Economic burden of common variable immunodeficiency: annual cost of disease

Abstract

Objectives: In the context of the unknown economic burden imposed by primary immunodeficiency diseases, in this study, we sought to calculate the costs associated with the most prevalent symptomatic disease, common variable immunodeficiency (CVID). Methods: Direct, indirect and intangible costs were recorded for diagnosed CVID patients. Hidden Markov model was used to evaluate different disease-related factors and Monte Carlo method for estimation of uncertainty intervals. Results: The total estimated cost of diagnosed CVID is US$274,200/patient annually and early diagnosis of the disease can save US$6500. Hospital admission cost (US$25,000/patient) accounts for the most important expenditure parameter before diagnosis, but medication cost (US$40,600/patients) was the main factor after diagnosis primarily due to monthly administration of immunoglobulin. Conclusion: The greatest cost-determining factor in our study was the cost of treatment, spent mostly on immunoglobulin replacement therapy of the patients. It was also observed that CVID patients’ costs are reduced after diagnosis due to appropriate management.

Keywords:

• common variable immunodeficiency
• cost
• economic burden
• primary immunodeficiency

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Indirect and intangible costs are two main proportions of primary immunodeficiency disease-specific disorder burden, which should be considered, as it accounts for more than half of total cost of disease.

• Significant different costs were observed regarding the model of disease, including location, income, knowledge about the disease and clinical phenotype of disease, which necessitates modeling of other primary immunodeficiency disease disorders before cost estimation.

• Although the diagnosis of common variable immunodeficiency has low impact on direct cost of disease, but due to better quality of life of patients resulting from Ig replacement, the intangible costs reduce significantly.