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免疫球蛋白替代疗法在血液系统恶性肿瘤继发免疫缺陷中的经济学影响:一项单中心观察性研究。

Economic impact of immunoglobulin replacement therapy in secondary immunodeficiency to hematological cancer: a single center observational study.

机构信息

Department of Immunology, Instituto de Medicina de Laboratorio (IML) and Instituto de Investigación Clínico San Carlos (IdISSC), Hospital Clínico San Carlos, Madrid, Spain.

Department of Immunology, Ophthalmology, and ENT, School of Medicine, Complutense University School of Medicine, Madrid, Spain.

出版信息

Front Immunol. 2024 Jun 26;15:1413231. doi: 10.3389/fimmu.2024.1413231. eCollection 2024.

Abstract

This is the first report of the health economic benefits derived from preventing infections through Immunoglobulin Replacement Therapy (IgRT) in patients with secondary immunodeficiency due to hematological malignancies. We conducted a retrospective population-based cohort study using patient medical history and pharmacy data from the Hospital Clínico San Carlos for 21 patients between 2011 and 2020. The pharmacoeconomic impact of using prophylactic IgRT was assessed by comparing characteristics of the SID patients 1 year before and after initiating IgRT measured by direct medical and tangible indirect costs. Results indicate a marked reduction in hospitalization days following IgRT initiation, decreasing from an average of 13.9 to 6.1 days per patient, with the elimination of ICU admissions. While emergency department visits decreased significantly, the number of routine consultations remained unchanged. Notably, absenteeism from work dropped substantially. The financial analysis revealed significant reductions in medication use and fewer ancillary tests, resulting in considerable cost savings. Specifically, total expenditure dropped from €405,088.18 pre-IgRT to €295,804.42 post-IgRT-including the cost of IgRT itself at €156,309.60. Overall, the annual savings amounted to €109,283.84, validating the cost-effectiveness of IgRT in managing SID in patients with hematological cancers.

摘要

这是首次报告通过免疫球蛋白替代疗法(IgRT)预防感染为继发免疫缺陷血液病患者带来的健康经济效益。我们使用 2011 年至 2020 年期间来自 Hospital Clínico San Carlos 的患者病史和药房数据,进行了一项回顾性基于人群的队列研究。通过直接医疗和有形间接成本,比较了开始 IgRT 前后 1 年 SID 患者的特征,评估了预防性 IgRT 的药物经济学影响。结果表明,IgRT 开始后,住院天数明显减少,每位患者从平均 13.9 天减少到 6.1 天,ICU 入院也得到了消除。急诊就诊显著减少,但常规就诊次数保持不变。值得注意的是,旷工显著减少。财务分析显示药物使用和辅助检查显著减少,从而节省了大量成本。具体来说,总支出从 IgRT 前的 405,088.18 欧元降至 IgRT 后的 295,804.42 欧元,包括 IgRT 本身的费用 156,309.60 欧元。总体而言,每年节省 109,283.84 欧元,验证了 IgRT 在管理血液病继发免疫缺陷患者中的成本效益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/422b/11234261/4dac53f928d6/fimmu-15-1413231-g001.jpg

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