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Direct and Indirect Costs of Immunoglobulin Replacement Therapy in Patients with Common Variable Immunodeficiency (CVID) and X-Linked Agammaglobulinemia (XLA) in Italy

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Abstract

Background

In Italy, there is scarce evidence on the epidemiological and economic burden induced by primary antibody deficiencies.

Objective

The aim of this study was to elaborate the available epidemiological and cost data in order to estimate the annual expenditure induced by the management of patients affected by the common variable immunodeficiency (CVID) and X-linked agammaglobulinemia (XLA) requiring immunoglobulin (Ig) replacement therapy.

Methods

A probabilistic cost-of-illness model was developed to estimate the number of patients with CVID and XLA, and the economic burden associated with their therapy in terms of direct or indirect costs. A systematic literature review was carried out to reveal both epidemiological and economic data. Furthermore, a probabilistic sensitivity analysis with 5000 Monte Carlo simulations was performed.

Results

The epidemiological model allowed us to estimate the number of prevalent patients affected by XLA and CVID in Italy in 2017, corresponding to 1885 (95% confidence interval [CI] 944–3145) and 133 (95% CI 115–152) patients, respectively. The estimated total expenditure for the treatment and management of patients with CVID and XLA requiring Ig replacement therapy amounts to €42.68 million (95% CI €14.38–€86.1 million).

Conclusions

This information provides a comprehensive perspective of the economic issues, and facilitates better-informed public health decision making, in the management of CVID and XLA in Italy.

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Authors and Affiliations

  1. Economic Evaluation and HTA (EEHTA), CEIS, Faculty of Economics, University of Rome “Tor Vergata”, Rome, Italy

    Raffaella Viti, Andrea Marcellusi, Alessandro Capone & Francesco Saverio Mennini

  2. Institute for Leadership and Management in Health, Kingston University London, London, UK

    Andrea Marcellusi & Francesco Saverio Mennini

  3. Immunoallergology Unit, AOU Careggi, University of Florence, Florence, Italy

    Andrea Matucci & Alessandra Vultaggio

  4. Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy

    Claudio Pignata

  5. Department of Translational Medical Sciences, Center for Basic and Clinical Immunology Research, University of Naples Federico II, Naples, Italy

    Giuseppe Spadaro

  6. Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine and Clinical Oncology, University of Bari Medical School, Bari, Italy

    Angelo Vacca & Carolina Marasco

  7. Department of Medicine (DIMED), Internal Medicine 1, Treviso Ca’ Foncello Hospital, University of Padua, Padua, Italy

    Carlo Agostini

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  1. Raffaella Viti
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  2. Andrea Marcellusi
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  3. Alessandro Capone
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  4. Andrea Matucci
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  11. Francesco Saverio Mennini
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Corresponding author

Correspondence to Andrea Marcellusi.

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Funding

This analysis was funded by Baxalta SpA. The authors confirm that the paper is an accurate representation of the study results.

Conflicts of interest

Viti Raffaella, Marcellusi Andrea, Capone Alessandro, Matucci Andrea, Vultaggio Alessandra, Pignata Claudio, Spadaro Giuseppe, Vacca Angelo, Marasco Carolina, Agostini Carlo, and Mennini Francesco Saverio declare that there are no conflicts of interest regarding the publication of this paper.

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Viti, R., Marcellusi, A., Capone, A. et al. Direct and Indirect Costs of Immunoglobulin Replacement Therapy in Patients with Common Variable Immunodeficiency (CVID) and X-Linked Agammaglobulinemia (XLA) in Italy. Clin Drug Investig 38, 955–965 (2018). https://doi.org/10.1007/s40261-018-0688-3

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  • DOI: https://doi.org/10.1007/s40261-018-0688-3

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