2022, Number 3
Economic Burden of Primary Immunodeficiencies estimated by Real-life Evidence at National Institute of Pediatrics
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ABSTRACTBackground: Primary Immunodeficiencies (PID) are genetic disorders impairing the immune system. Approximately, 85% of PID patients will need replacement therapy with human immunoglobulin (IG). Diagnosis and treatment delay may produce complications, and elevated expenses for the health systems.
Objectives: To evaluate the economic burden of PID and to compare the financial load before and after the initiation of replacement treatment with IG.
Methods: Health care costs analysis in patients with PID. We obtained information about health resources use directly from clinical records through a bottom-up approach, it was revised by clinical immunologists, and we developed medical-economic cards for registering resource allocation and costs. We then ran a budget impact analysis by a top-down approach considering the 109 PID patients currently under clinical follow-up at our institution.
Results: Total cost for treating infections per patient per year before diagnosis and IG replacement was MXN$ 629,299.00 vs MXN$ 155,546.00 after IG treatment, resulting in 75.3% cost reduction. Pneumonia is the most expensive complication. After initiating IG therapy, the total cost of treating infections reduced to MXN$ 155,546.00 representing 75.3% in savings. Total costs per infections estimated for 109 patients before diagnosis and treatment was MXN$ 68.5 million vs MXN$ 36 million after IG treatment. Based on the reference population for our institution, per-capita cost was MXN$ 3.96 before vs MXN$ 2.10 after IG treatment.
Conclusions: Timely diagnosis and treatment of PID patients with IG significantly decreased the per-capita costs of health care by MXN$ 1.87, which represents annual savings of 47%.
Costa-Carvalho BT, Grumach AS, Franco JL, Espinosa-Rosales FJ, Leiva LE, King A, Porras O, Bezrodnik L, OleastroM, Sorensen RU, Condino-Neto A. Attending to WarningSigns of Primary Immunodeficiency. Diseases across theRange of Clinical Practice. J Clin Immunol 2014; 34:10–22.DOI 10.1007/s10875-013-9954-6.