A Systematic Review of the Cost and Cost-effectiveness of Immunoglobulin Treatment in Patients with Hematological Malignancies

Overview

Journal Int J Technol Assess Health Care

Publisher Cambridge University Press

Specialties Biotechnology
Health Services

Date 2024 May 16

PMID 38751245

Authors

Sara Carrillo de Albornoz

Khai Li Chai

Alisa M Higgins

Dennis Petrie

Erica M Wood

Zoe K McQuilten

Affiliations

Soon will be listed here.

Abstract

Objectives: Patients with hematological malignancies are likely to develop hypogammaglobulinemia. Immunoglobulin (Ig) is commonly given to prevent infections, but its overall costs and cost-effectiveness are unknown.

Methods: A systematic review was conducted following the PRISMA guidelines to assess the evidence on the costs and cost-effectiveness of Ig, administered intravenously (IVIg) or subcutaneously (SCIg), in adults with hematological malignancies.

Results: Six studies met the inclusion criteria, and only two economic evaluations were identified; one cost-utility analysis (CUA) of IVIg versus no Ig, and another comparing IVIg with SCIg. The quality of the evidence was low. Compared to no treatment, Ig reduced hospitalization rates. One study reported no significant change in hospitalizations following a program to reduce IVIg use, and an observational study comparing IVIg with SCIg suggested that there were more hospitalizations with SCIg but lower overall costs per patient. The CUA comparing IVIg versus no Ig suggested that IVIg treatment was not cost-effective, and the other CUA comparing IVIg to SCIg found that home-based SCIg was more cost-effective than IVIg, but both studies had serious limitations.

Conclusions: Our review highlighted key gaps in the literature: the cost-effectiveness of Ig in patients with hematological malignancies is very uncertain. Despite increasing Ig use worldwide, there are limited data regarding the total direct and indirect costs of treatment, and the optimal use of Ig and downstream implications for healthcare resource use and costs remain unclear. Given the paucity of evidence on the costs and cost-effectiveness of Ig treatment in this population, further health economic research is warranted.

Citing Articles

Healthcare resource utilization and costs in immunodeficient patients receiving subcutaneous Ig: Real-world evidence from France.

Lefevre G, Borget I, Lefevre C, Maherzi C, Nucit A, Hennaoui M PLoS One. 2025; 20(1):e0313694.

PMID: 39854356 PMC: 11759344. DOI: 10.1371/journal.pone.0313694.

Economic evaluation: immunoglobulin vs prophylactic antibiotics in hypogammaglobulinemia and hematological malignancies.

Carrillo de Albornoz S, Higgins A, Petrie D, Irving A, Fanning L, Weinkove R Blood Adv. 2024; 8(9):2259-2267.

PMID: 38484199 PMC: 11116992. DOI: 10.1182/bloodadvances.2023012047.

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