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dc.contributor.authorWindegger, Tanja M
dc.contributor.authorNghiem, Son
dc.contributor.authorKim-Huong, Nguyen
dc.contributor.authorFung, Yoke-Lin
dc.contributor.authorScuffham, Paul A
dc.date.accessioned2019-08-01T04:49:25Z
dc.date.available2019-08-01T04:49:25Z
dc.date.issued2019
dc.identifier.issn0042-9007
dc.identifier.doi10.1111/vox.12760
dc.identifier.urihttp://hdl.handle.net/10072/384677
dc.description.abstractBackground and Objective Immunoglobulin replacement therapy (IRT) is often used to support patients with primary immunodeficiency disease (PID) and secondary immunodeficiency disease (SID). Home‐based subcutaneous immunoglobulin (SCIg) is reported to be a cheaper and more efficient option compared to hospital‐based intravenous immunoglobulin (IVIg) for PID. In contrast, there is little information on the cost‐effectiveness of IRT in SID. However, patients who develop hypogammaglobulinaemia secondary to other conditions (SID) have different clinical aetiology compared to PID. This study assesses whether SCIg provides a good value‐for‐money treatment option in patients with secondary immunodeficiency disease (SID). Methods A Markov cohort simulation model with six health states was used to compare cost‐effectiveness of IVIg with SCIg from a healthcare system perspective. The costs of treatment, infection and quality‐adjusted life years (QALYs) for IVIg and SCIg treatment options were modelled with a time horizon of 10 years and weekly cycles. Deterministic and probabilistic sensitivity analyses were performed around key parameters. Results The cumulative cost for IVIg was A$151 511 and for SCIg A$144 296. The QALYs with IVIg were 3·07 and with SCIg 3·51. Based on the means, SCIg is the dominant strategy with better outcomes and at lower cost. The probabilistic sensitivity analysis shows that 88·3% of the 50 000 iterations fall below the nominated willingness to pay threshold of A$50 000 per QALY. Therefore, SCIg is a cost‐effective treatment option. Conclusion For SID patients in Queensland (Australia), the home‐based SCIg treatment option provides better health outcomes and cost savings.
dc.description.peerreviewedYes
dc.description.sponsorshipTownsville Hospital and Health Service
dc.description.sponsorshipCommonwealth Department of Health
dc.description.sponsorshipGriffith University
dc.languageEnglish
dc.publisherWILEY
dc.relation.ispartofpagefrom237
dc.relation.ispartofpageto246
dc.relation.ispartofissue3
dc.relation.ispartofjournalVOX SANGUINIS
dc.relation.ispartofvolume114
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchcode1103
dc.titleCost-utility analysis comparing hospital-based intravenous immunoglobulin with home-based subcutaneous immunoglobulin in patients with secondary immunodeficiency
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.rights.copyright© 2019 International Society of Blood Transfusion. This is the peer reviewed version of the following article: Cost–utility analysis comparing hospital‐based intravenous immunoglobulin with home‐based subcutaneous immunoglobulin in patients with secondary immunodeficiency, Vox Sanguinis, Vol. 114, 237–246, 2019, which has been published in final form at 10.1111/vox.12760. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)
gro.hasfulltextFull Text
gro.griffith.authorFung, Lin
gro.griffith.authorNghiem, Son H.
gro.griffith.authorNguyen, Kim-Huong
gro.griffith.authorScuffham, Paul A.


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