Division of Allergy and Clinical Immunology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Division of Allergy and Clinical Immunology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Ann Allergy Asthma Immunol. 2018 Feb;120(2):195-199. doi: 10.1016/j.anai.2017.11.002.
Home-based subcutaneous immunoglobulin (SCIg) administration used for immunoglobulin replacement therapy for patients with primary immunodeficiency has been demonstrated to have benefits compared with hospital-based intravenous immunoglobulin (IVIg) therapy.
To estimate the cost savings associated with treating eligible patients with primary immunodeficiency with home-based SCIg compared with hospital-based IVIg in a prospective study.
This study was a 12-month prospective observational study that collected information from patient charts, directly from the nurse for time spent with patients and materials used, and directly from the physicians for billing. Data were collected on case report forms at each follow-up. Data were entered in a web-based REDCap database and statistical comparisons were performed.
The average hospital (including hospital personnel such as nurses) and physician costs were significantly lower in the SCIg group ($1,836 and $84, respectively) than in the IVIg group ($4,187 and $744, respectively), which supported the findings in the number of hospital and physician visits in each group. The total cost was reported from the hospital's (only hospital-related costs) and the health system's (hospital- and physician-related costs) perspectives. For the 2 perspectives, the SCIg group reported significantly lower average total costs than the IVIg group.
This is the first prospective analysis of the cost savings associated with home-based SCIG therapy compared with hospital-based IVIG therapy. These findings could help justify provision of home-based therapy training to suitable patients to lower health care costs or improve the capacity of care.
家庭皮下免疫球蛋白（SCIg）给药用于原发性免疫缺陷患者的免疫球蛋白替代疗法，已被证明与医院静脉内免疫球蛋白（IVIg）疗法相比具有优势。
在一项前瞻性研究中，估计与医院为基础的 IVIg 相比，用家庭为基础的 SCIg 治疗符合条件的原发性免疫缺陷患者的相关成本节省。
这是一项为期 12 个月的前瞻性观察研究，从患者病历、直接从护士处获取与患者相处的时间和使用的材料以及直接从医生处获取计费信息中收集信息。每次随访都在病例报告表上收集数据。数据被输入基于网络的 REDCap 数据库，并进行了统计比较。
SCIg 组的平均医院（包括护士等医院人员）和医生成本明显低于 IVIg 组（分别为 1836 美元和 84 美元），这支持了每组医院和医生就诊次数的发现。从医院（仅与医院相关的成本）和卫生系统（医院和医生相关的成本）的角度报告了总成本。对于这 2 个角度，SCIg 组报告的平均总成本明显低于 IVIg 组。
这是第一项关于与医院为基础的 IVIg 治疗相比，家庭为基础的 SCIG 治疗相关成本节省的前瞻性分析。这些发现可能有助于证明为合适的患者提供家庭治疗培训以降低医疗保健成本或提高护理能力的合理性。
