Home-based subcutaneous immunoglobulin for chronic inflammatory demyelinating polyneuropathy patients: A Swiss cost-minimization analysis

To compare the cost of two patient management strategies with similar efficacies for chronic inflammatory demyelinating polyneuropathy (CIDP) patients in the chronic phase: hospital-based IV immunoglobulin G (IVIg) and home-based subcutaneous immunoglobulin G (SCIg) associated with an interprofessio...

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Bibliographic Details
Published in:PloS one Vol. 15; no. 11; p. e0242630
Main Authors: Perraudin, Clémence, Bourdin, Aline, Vicino, Alex, Kuntzer, Thierry, Bugnon, Olivier, Berger, Jérôme
Format: Journal Article
Language:English
Published: United States Public Library of Science 25.11.2020
Public Library of Science (PLoS)
Subjects:
Analysis
Biology and Life Sciences
Chemotherapy
Cost analysis
Cost-Benefit Analysis
Costs
Demyelinating diseases
Demyelination
Drug dosages
Drug therapy
Economic aspects
Health care costs
Health insurance
Home Care Services - economics
Hospitals
Humans
IgG antibody
Immunoglobulin G
Immunoglobulins
Immunoglobulins, Intravenous - administration & dosage
Immunoglobulins, Intravenous - economics
Inflammation
Infusions, Subcutaneous
Insurance
Intravenous administration
Intravenous immunoglobulins
Maintenance
Medication Therapy Management - economics
Medicine and Health Sciences
Neurosciences
Optimization
Patients
People and Places
Pharmaceutical sciences
Pharmacy
Polyneuropathies
Polyneuropathy
Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - drug therapy
Polyradiculoneuropathy, Chronic Inflammatory Demyelinating - economics
Primary care
Professionals
Public health
Social Sciences
Switzerland
Training
Switzerland
United States > US
ISSN:1932-6203, 1932-6203
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Description
Summary:To compare the cost of two patient management strategies with similar efficacies for chronic inflammatory demyelinating polyneuropathy (CIDP) patients in the chronic phase: hospital-based IV immunoglobulin G (IVIg) and home-based subcutaneous immunoglobulin G (SCIg) associated with an interprofessional drug therapy management programme (initial training and follow-up). A 48-week model-based cost-minimization analysis from a societal perspective was performed. Resources included immunoglobulin (IVIg: 1 g/kg/3 weeks; SCIg: 0.4 g/kg/week initially and 0.2 g/kg/week in the maintenance phase), hospital charges, time of professionals, infusion material, transport and losses of productivity for patients. Costs were expressed in Swiss francs (CHF) (1 CHF = 0.93€ = US$1.10, www.xe.com, 2020/10/28). The total costs of IVIg were higher than those of SCIg for health insurance and other payers: 114,747 CHF versus 86,558 CHF and 8,762 CHF versus 2,401 CHF, respectively. The results were sensitive to the immunoglobulin doses, as this was the main cost driver. The SCIg daily cost in the initial phase was higher for health insurance than hospital-based IVIg was, but the additional costs were compensated during the maintenance phase (from week 28). The professional costs associated with the switch were not fully covered by the insurance and were borne by the pharmacist and the nurse. SCIg for CIDP patients reinforced by an interprofessional drug therapy management programme may be a cost-effective and sustainable alternative to IVIg in the Swiss system context. From an economic perspective, this therapy alternative should be more widely supported by healthcare systems and proposed to eligible patients by professionals.
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Competing Interests: The authors have declared that no competing interests exist.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0242630