Subcutaneous vs intravenous administration of immunoglobulin in chronic inflammatory demyelinating polyneuropathy: an Italian cost-minimization analysis.
Prior researches have suggested that home-based subcutaneous immunoglobulin (SCIG) is equally effective and can be less expensive than hospital-based intravenous immunoglobulin (IVIG) in treating chronic inflammatory demyelinating polyneuropathy (CIDP) patients. This economic evaluation aims at comparing costs of SCIG vs IVIG for CIDP patients in Italy. A 1-year model-based cost-minimization analysis basically populated via neurologists' opinion was undertaken from a societal perspective. Health care resources included immunoglobulin; drugs for premedication and complications (rash, headache, and hypertension) management; time of various health care professionals; pump for SCIG self-administration; infusion disposables. Non-health care resources encompassed transport and parking; losses of working and leisure time for patients and caregivers. Unit or yearly costs for resources valuation were mainly obtained from published sources. Costs were expressed in Euro (<euro>) 2013. An extensive one-way sensitivity analysis (OWSA) and a scenario SA tested the robustness of the base case findings. Overall costs per patient amount to <euro>49,534.75 (SCIG) and <euro>50,895.73 (IVIG); saving in favour of SCIG reaches <euro>1360.98. For both SCIG and IVIG, the cost driver was immunoglobulin (94.06 vs 86.06 % of the overall costs, respectively). Sensitivity analyses confirmed the consistency of the baseline results. SCIG may be a cost-saving therapy for Italian CIDP patients.
Studio di Economia Sanitaria, Via Stefanardo da Vimercate, 19, 20128, Milan, Italy, carlo.lazzaro@tiscalinet.it.
Carlo
C
Lazzaro
Leonardo
L
Lopiano
Dario
D
Cocito
D061605:Administration, Intravenous / Q000191:economics* / Q000379:methods; D000367:Age Factors; D017028:Caregivers / Q000191:economics / Q000523:psychology; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000191:economics / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000191:economics / Q000627:therapeutic use*; D055104:Infusions, Subcutaneous / Q000191:economics* / Q000379:methods; D007558:Italy; D008137:Longitudinal Studies; D008297:Male; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000188:drug therapy* / Q000191:economics; D012680:Sensitivity and Specificity
D007136:Immunoglobulins; D007155:Immunologic Factors