Skip to main content

Advertisement

Log in

Healthcare resource utilization and cost of care for Gaucher patients in Iran

  • Research Article
  • Published:
Journal of Diabetes & Metabolic Disorders Aims and scope Submit manuscript

Abstract

Introduction

Gaucher disease (GD) is an inherited recessive enzyme deficiency with a multisystem condition. The Iranian government covers the therapeutic expenditure of GD patients as it is not affordable for the patients. The aim of this study is to identify the main components of the cost of care in Gaucher patients (GPs) in Iran.

Methods

The Gaucher patients were identified from the Iran Food and Drug Administration (IFDA) national registry database. The direct medical costs, including medication, diagnostic services, and physician visits were considered. The prices of therapeutic and diagnostic services were extracted from Iranian medical tariff book 2014–15. Iran Food and Drug Administration determined the cost of medications.

Results

164 Gaucher patients have been registered in Iran. A valid and reliable diagnostic tests are not used to identify the type of GD. The average health care cost per annum was 20,758 USD per patient, which is higher than 4 GDP per capita in Iran. Medication cost constitutes 95.2% of the total cost. The average cost of each GP was $1,473,818 in his/her total life.

Conclusion

GD is amongst the high-cost diseases and should be managed effectively. The application of oral medication for eligible GPs could improve allocative efficiency in GD management significantly. A sound, valid and reliable national clinical guideline could improve the efficiency of healthcare resources effectively. Selecting appropriate strategies for reducing the birth of a child with Gaucher, could support allocative efficiency of the limited resources effectively.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Biegstraaten M, Van Schaik I, Aerts J, Hollak C. Non-neuronopathic’Gaucher disease reconsidered. Prevalence of neurological manifestations in a Dutch cohort of type I Gaucher disease patients and a systematic review of the literature. J Inherit Metab Dis. 2008;31(3):337–49.

    Article  CAS  PubMed  Google Scholar 

  2. Keatinge M, Bui H, Menke A, Chen Y-C, Sokol AM, Bai Q, et al. Glucocerebrosidase 1 deficient Danio rerio mirror key pathological aspects of human Gaucher disease and provide evidence of early microglial activation preceding alpha-synuclein-independent neuronal cell death. Hum Mol Genet. 2015;24(23):6640–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Machaczka M. What hematologist needs to know about Gaucher disease. Acta Haematol Pol. 2013;44:301–6.

    Article  Google Scholar 

  4. Zimran A. How I treat Gaucher disease. Blood. 2011;118(6):1463–71.

    Article  CAS  PubMed  Google Scholar 

  5. Mistry P, Weinthal J, Weinreb N. Disease state awareness in Gaucher disease: a Q&A expert roundtable discussion. Clin Adv Hematol Oncol: H&O. 2012;10(6 Suppl 8):1–16.

    Google Scholar 

  6. Barranger JA, Brady RO, Grabowski GA, Mankin H, Mistry PK, Weinreb NJ. Position statement: National Gaucher Foundation Medical Advisory Board, January 7, 2014. Am J Hematol. 2014;89(5):457–8.

    Article  PubMed  Google Scholar 

  7. Barton NW, Brady RO, Dambrosia JM, Di Bisceglie AM, Doppelt SH, Hill SC, et al. Replacement therapy for inherited enzyme deficiency—macrophage-targeted glucocerebrosidase for Gaucher's disease. N Engl J Med. 1991;324(21):1464–70.

    Article  CAS  PubMed  Google Scholar 

  8. Gonzalez DE, Turkia HB, Lukina EA, Kisinovsky I, Dridi MFB, Elstein D, et al. Enzyme replacement therapy with velaglucerase alfa in Gaucher disease: results from a randomized, double-blind, multinational, phase 3 study. Am J Hematol. 2013;88(3):166–71.

    Article  CAS  PubMed  Google Scholar 

  9. Grabowski GA, Barton NW, Pastores G, Dambrosia JM, Banerjee TK, McKee MA, et al. Enzyme therapy in type 1 Gaucher disease: comparative efficacy of mannose-terminated glucocerebrosidase from natural and recombinant sources. Ann Intern Med. 1995;122(1):33–9.

    Article  CAS  PubMed  Google Scholar 

  10. Weinreb NJ, Charrow J, Andersson HC, Kaplan P, Kolodny EH, Mistry P, et al. Effectiveness of enzyme replacement therapy in 1028 patients with type 1 Gaucher disease after 2 to 5 years of treatment: a report from the Gaucher registry. Am J Med. 2002;113(2):112–9.

    Article  CAS  PubMed  Google Scholar 

  11. Charrow J, Dulisse B, Grabowski G, Weinreb N. The effect of enzyme replacement therapy on bone crisis and bone pain in patients with type 1 Gaucher disease. Clin Genet. 2007;71(3):205–11.

    Article  CAS  PubMed  Google Scholar 

  12. Wenstrup R, Roca-Espiau M, Weinreb N, Bembi B. Skeletal aspects of Gaucher disease: a review. Br J Radiol. 2002;75(suppl_1):A2–A12.

    Article  PubMed  Google Scholar 

  13. Elstein D, Hadas-Halpern I, Itzchaki M, Lahad A, Abrahamov A. Effect of low-dose enzyme replacement therapy on bones in Gaucher disease patients with severe skeletal involvement. Blood Cell Mol Dis. 1996;22(2):104–11.

    Article  CAS  Google Scholar 

  14. Chen M, Wang J. Gaucher disease: review of the literature. Arch Pathol Lab Med. 2008;132(5):851–3.

    PubMed  Google Scholar 

  15. Cox TM, Drelichman G, Cravo R, Balwani M, Burrow TA, Martins AM, et al. Eliglustat compared with imiglucerase in patients with Gaucher's disease type 1 stabilised on enzyme replacement therapy: a phase 3, randomised, open-label, non-inferiority trial. Lancet. 2015;385(9985):2355–62.

    Article  CAS  PubMed  Google Scholar 

  16. Mignot C, Doummar D, Maire I, De Villemeur TB, Group FTGDS. Type 2 Gaucher disease: 15 new cases and review of the literature. Brain Dev. 2006;28(1):39–48.

    Article  PubMed  Google Scholar 

  17. Weinreb NJ, Aggio MC, Andersson HC, Andria G, Charrow J, Clarke JT, et al., editors. Gaucher disease type 1: revised recommendations on evaluations and monitoring for adult patients. Seminars in hematology; 2004: Elsevier.

  18. Weinreb NJ, Deegan P, Kacena KA, Mistry P, Pastores GM, Velentgas P, et al. Life expectancy in Gaucher disease type 1. Am J Hematol. 2008;83(12):896–900.

    Article  PubMed  PubMed Central  Google Scholar 

  19. World Health Organization (WHO). Global Health Observatory (GHO) date 2015. Available from: http://search.who.int/search?q=iran+life+expectancy&ie=utf8&site=who&client=_en_r&proxystylesheet=_en_r&output=xml_no_dtd&oe=utf8&getfields=doctype. Accessed 2 Dec 2017.

  20. Belmatoug N, Di Rocco M, Fraga C, Giraldo P, Hughes D, Lukina E, et al. Management and monitoring recommendations for the use of eliglustat in adults with type 1 Gaucher disease in Europe. Eur J Intern Med. 2017;37:25–32.

    Article  CAS  PubMed  Google Scholar 

  21. Smid BE, Hollak CE. A systematic review on effectiveness and safety of eliglustat for type 1 Gaucher disease. Expert Opin Orphan Drugs. 2014;2(5):523–9.

    Article  CAS  Google Scholar 

  22. Krug B, Schwartz I, De Oliveira FL, Alegra T, Martins NC, Todeschini L, et al. The management of Gaucher disease in developing countries: a successful experience in Southern Brazil. Public Health Genomics. 2010;13(1):27–33.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We would like to acknowledge the IFDA staffs, particularly Dr. Zolfaghar Taghaviyan who were supportive during data collection from IFDA database.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Azita Nabizadeh.

Ethics declarations

Ethical approval

The study was approved by the Faculty of pharmacy and Research Ethics Committee of the Tehran University of Medical Sciences.

Conflicts of interests

The authors declare that they have no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Davari, M., Nabizadeh, A., Kadivar, M. et al. Healthcare resource utilization and cost of care for Gaucher patients in Iran. J Diabetes Metab Disord 18, 127–132 (2019). https://doi.org/10.1007/s40200-019-00399-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40200-019-00399-x

Keywords

Navigation