Cost-Minimization Analysis of 10% Intravenous Immunoglobulin In Treatment Of Primary Immunodeficiencies In Children In The Russian Federation

Abstract

To conduct cost-minimization analysis of 10% liquid intravenous immunoglobulin (IVIG) compared with IVIGs of 5% concentration in treatment of primary immunodeficiencies (PID) in children in Russia for 1-year period. A cost-minimization model was developed in Excel 2013 to simulate the direct and indirect costs for 1-year period. Costs included ones for treatment course with IVIGs and IVIG administration, expenditures of infections' treatment, ones associated with storage and transportation of IVIG, disability pensions and payment for sick leave in connection with caring for a sick child. The following sources were used for calculations: epidemiological data from Ministry of health reports, database of tenders for purchase of medicines, prescribing Information for the drugs, Federal statistical monitoring in the sphere of payment of labour of social workers, tariffs for payment of medical care in stationary conditions on completed cases, requirements of sanitary-epidemiological rules, wholesale prices on refrigerated equipment, the duration of the absence of children in educational institution because of PID according to Stein et al.,2009. According to the cost-minimization analysis, 10% IVIG (Switzerland) therapy (552,618 rubles/9,690 $) is the least costly by the end of the 1 year per 1 patient. Therapy with 5% IVIG (Italy) costs 621,567 rubles/10 899 $, 5% IVIG (Austria) and 5% IVIG (Germany) cost 618,223 rubles/10,840 $ and 736,243 rubles/12,910 $ consequently. Current rate taken as for 15.06.2017 is 1$ = 57,03 RUB. The treatment of primary immunodeficiencies with 10% liquid intravenous immunoglobulin (Switzerland) is a cost saving option compared with treatment with 5% IVIGs in children in Russia for 1-year period.