Cost-effectiveness analysis of subcutaneous immunoglobulin replacement therapy in Iranian patients with primary immunodeficiencies

Abstract

Background: Economic evaluation of subcutaneous immunoglobulin therapy (SCIG) is important, and it has recently been used for treatment of patients with primary immunodeficiency (PID) diseases, and can improve allocation of resources in health care systems. The present research aimed at providing an economic assessment of SCIG and IVIG (intravenous immunoglobulin therapy) administration in Iran. Methods: Data related to clinical effectiveness were obtained from a meta-analysis. Economic analysis was performed taking into account the perspective of health care providers. Incremental cost-effectiveness ratio (ICER) was applied for economic evaluation of the 2 methods, and GDP per capita was considered as a threshold. Results: The results of meta-analysis suggested a higher effectiveness of SCIG compared to IVIG in serum immunoglobulin (Ig) levels (SMD= 0.336) and adverse effects (OR= 0.497), while the cost of IVIG was higher than SCIG ($1370 vs. $121). The ICER obtained in this paper ($2939 for adverse effects and $4348 for serum Ig level) was less than the GDP per capita in Iran ($4,916.10), and thus SCIG is a more cost-effective therapy for PID patients. Conclusion: Switching from IVIG to SCIG is cost-effective for PID patients and is approved by the health care providers’ points of view in this study.

Ten-year population trends of immunoglobulin use, burden of adult antibody deficiency and feasibility of subcutaneous immunoglobulin (SCIg) replacement in Hong Kong Chinese

“…Furthermore, we also demonstrated that SCIg is more costeffective than IVIg as a form of immunoglobulin replacement for adult patients in Hong Kong. Our finding is similar to that of other cost-effective analysis studies in Australia, Canada, Iran, Spain, France, Japan and Switzerland (52)(53)(54)(55)(56)(57)(58). Projecting from the costs saved from immunodeficiency-related hospitalisation costs alone, we could potentially save HKD25,286 (USD3,221) per patient per year on SCIg compared to IVIg.…”

Trends in IVIG use at a tertiary care Canadian center and impact of provincial use mitigation strategies: 10‐year retrospective study with interrupted time series analysis

“…SCIG can be self‐administered and is preferred by many patients. The economic advantage of switching to SCIG from hospital‐based IVIG therapy has been widely reported . Future use audits of immunoglobulin therapies would benefit from the comparative assessment of IVIG and SCIG administration to determine if changes in IVIG and SCIG are correlated.…”

Diagnostik und Therapie bei primären Immundefekten/„inborn errors of immunity“

“…Antikörpermangelerkrankungen stellen die größte Gruppe der angeborenen Immundefekte dar. Der Nutzen einer Immunglobulinersatztherapie konnte in vielen Kohortenstudien belegt werden [44,45,46,47]. Ziel einer Immunglobulin Therapie ist es die Anzahl an infektiösen Erkrankungen zu minimieren.…”