title: Social costs of icatibant self-administration vs. health professional-administration in the treatment of hereditary angioedema in Spain.
abstract: BACKGROUND
  Icatibant is the only subcutaneous treatment for acute Type I and Type II hereditary angioedema with C1-esterase inhibitor deficiency (HAE-C1-INH) licensed for self-administration in Europe.
  
  
  OBJECTIVE
  To compare the economic impact of two icatibant administration strategies: health professional-administration only (strategy 1) versus including the patient self-administration option (strategy 2).
  
  
  METHODS
  Economic evaluation model based on the building of a decision tree. Both strategies are assumed to have equivalent effectiveness. The payer (Spanish National Health System) and the social perspectives were considered. All relevant cost-generating factors were taken into account. The time horizon was one year. Sources of information included scientific evidence, official data and experts' opinion. A deterministic sensitivity analysis was carried out to quantify the underlying uncertainty in the model.
  
  
  RESULTS
  From the social perspective, which considers both direct (health care costs) and indirect costs (productivity losses), strategy 2 would result into average savings of €121.30 per acute attack compared to strategy 1. For Spain, this would achieve in an annual savings of €551,371. The reduction in direct costs accounts for 74% of the savings and lower indirect costs account for the remaining 26%. Savings per acute attack may range from €79.50 to €169.80; accordingly, the annual savings in Spain may vary between €90,319 and €2,315,360.
  
  
  CONCLUSIONS
  Costs related to the management of acute HAE attacks with C1 inhibitor deficiency may be substantially reduced through interventions targeting home treatment by training patients to self-administer icatibant.
authors: Advanced Techniques in Health Services Research (TAISS), Madrid, Spain. ablasco@taiss.com.
authors: Antonio J
authors: AJ
authors: Blasco
authors: Pablo
authors: P
authors: Lázaro
authors: Teresa
authors: T
authors: Caballero
authors: Mar
authors: M
authors: Guilarte
references: J Allergy Clin Immunol. 2007 Jun;119(6):1497-503
references: 17418383
references: J Investig Allergol Clin Immunol. 2011;21(6):422-41; quiz 442-3
references: 21995176
references: Allergy. 2012 Feb;67(2):147-57
references: 22126399
references: N Engl J Med. 2010 Aug 5;363(6):532-41
references: 20818888
references: Eur J Dermatol. 2009 Mar-Apr;19(2):147-51
references: 19264579
references: Core Evid. 2012;7:105-14
references: 23055948
references: J Investig Allergol Clin Immunol. 2011;21(5):333-47; quiz follow 347
references: 21905496
references: PLoS One. 2013;8(2):e53773
references: 23390491
references: Mayo Clin Proc. 2000 Apr;75(4):349-54
references: 10761488
references: Allergy Asthma Clin Immunol. 2010 Jul 28;6(1):22
references: 20667125
references: J Am Dent Assoc. 2003 Aug;134(8):1088-94
references: 12956349
references: Clin Exp Immunol. 2012 Jun;168(3):303-7
references: 22519593
references: J Allergy Clin Immunol. 2004 Sep;114(3 Suppl):S51-131
references: 15356535
references: Allergy Asthma Clin Immunol. 2010 Jul 28;6(1):24
references: 20667127