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1.
Ann Allergy Asthma Immunol ; 120(2): 195-199, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-29413344

RESUMEN

BACKGROUND: Home-based subcutaneous immunoglobulin (SCIg) administration used for immunoglobulin replacement therapy for patients with primary immunodeficiency has been demonstrated to have benefits compared with hospital-based intravenous immunoglobulin (IVIg) therapy. OBJECTIVE: To estimate the cost savings associated with treating eligible patients with primary immunodeficiency with home-based SCIg compared with hospital-based IVIg in a prospective study. METHODS: This study was a 12-month prospective observational study that collected information from patient charts, directly from the nurse for time spent with patients and materials used, and directly from the physicians for billing. Data were collected on case report forms at each follow-up. Data were entered in a web-based REDCap database and statistical comparisons were performed. RESULTS: The average hospital (including hospital personnel such as nurses) and physician costs were significantly lower in the SCIg group ($1,836 and $84, respectively) than in the IVIg group ($4,187 and $744, respectively), which supported the findings in the number of hospital and physician visits in each group. The total cost was reported from the hospital's (only hospital-related costs) and the health system's (hospital- and physician-related costs) perspectives. For the 2 perspectives, the SCIg group reported significantly lower average total costs than the IVIg group. CONCLUSION: This is the first prospective analysis of the cost savings associated with home-based SCIG therapy compared with hospital-based IVIG therapy. These findings could help justify provision of home-based therapy training to suitable patients to lower health care costs or improve the capacity of care.


Asunto(s)
Inmunización Pasiva , Inmunoglobulina G/uso terapéutico , Inmunoglobulinas Intravenosas/uso terapéutico , Síndromes de Inmunodeficiencia/economía , Autocuidado/métodos , Administración Intravenosa , Canadá , Análisis Costo-Beneficio , Costos y Análisis de Costo , Estudios de Seguimiento , Humanos , Síndromes de Inmunodeficiencia/terapia , Inyecciones Subcutáneas , Educación del Paciente como Asunto , Estudios Prospectivos , Autoadministración
2.
Front Immunol ; 15: 1413231, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38989286

RESUMEN

This is the first report of the health economic benefits derived from preventing infections through Immunoglobulin Replacement Therapy (IgRT) in patients with secondary immunodeficiency due to hematological malignancies. We conducted a retrospective population-based cohort study using patient medical history and pharmacy data from the Hospital Clínico San Carlos for 21 patients between 2011 and 2020. The pharmacoeconomic impact of using prophylactic IgRT was assessed by comparing characteristics of the SID patients 1 year before and after initiating IgRT measured by direct medical and tangible indirect costs. Results indicate a marked reduction in hospitalization days following IgRT initiation, decreasing from an average of 13.9 to 6.1 days per patient, with the elimination of ICU admissions. While emergency department visits decreased significantly, the number of routine consultations remained unchanged. Notably, absenteeism from work dropped substantially. The financial analysis revealed significant reductions in medication use and fewer ancillary tests, resulting in considerable cost savings. Specifically, total expenditure dropped from €405,088.18 pre-IgRT to €295,804.42 post-IgRT-including the cost of IgRT itself at €156,309.60. Overall, the annual savings amounted to €109,283.84, validating the cost-effectiveness of IgRT in managing SID in patients with hematological cancers.


Asunto(s)
Análisis Costo-Beneficio , Neoplasias Hematológicas , Humanos , Neoplasias Hematológicas/terapia , Neoplasias Hematológicas/economía , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Adulto , Síndromes de Inmunodeficiencia/economía , Síndromes de Inmunodeficiencia/terapia , Síndromes de Inmunodeficiencia/tratamiento farmacológico , Inmunización Pasiva/economía , Anciano , Costos de la Atención en Salud , Hospitalización/economía
3.
Transfus Med ; 23(1): 55-60, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23167310

RESUMEN

OBJECTIVE: The objective of this study is to evaluate the economic benefits of immunoglobulin replacement therapy achieved subcutaneously (subcutaneous immunoglobulin, SCIG) by the rapid push method compared to intravenous infusion therapy (intravenous immunoglobulin, IVIG) in primary immune deficiency (PID) patients from the healthcare system perspective in the context of the adult SCIG home infusion program based at St Paul's Hospital, Vancouver, Canada. MATERIALS AND METHODS: SCIG and IVIG options were compared in cost-minimisation and budget impact models (BIMs) over 3 years. Sensitivity analyses were performed for both models to evaluate the impact of varying modality of IVIG treatments and proportion of patients switching from IVIG to SCIG. RESULTS: The cost-minimisation model estimated that SCIG treatment reduced cost to the healthcare system per patient of $5736 over 3 years, principally because of less use of hospital personnel. This figure varied between $5035 and $8739 depending on modality of IVIG therapy. Assuming 50% of patients receiving IVIG switched to SCIG, the BIM estimated cost savings for the first 3 years at $1·308 million or 37% of the personnel and supply budget. These figures varied between $1·148 million and $2·454 million (36 and 42%) with varying modalities of IVIG therapy. If 75% of patients switched to SCIG, the reduced costs reached $1·962 million or 56% of total budget. CONCLUSION: This study demonstrated that from the health system perspective, rapid push home-based SCIG was less costly than hospital-based IVIG for immunoglobulin replacement therapy in adult PID patients in the Canadian context.


Asunto(s)
Inmunización Pasiva/métodos , Inmunoglobulinas Intravenosas/uso terapéutico , Síndromes de Inmunodeficiencia/terapia , Adulto , Colombia Británica , Presupuestos/estadística & datos numéricos , Ahorro de Costo/estadística & datos numéricos , Gastos en Salud/estadística & datos numéricos , Servicios de Atención a Domicilio Provisto por Hospital/economía , Costos de Hospital/estadística & datos numéricos , Humanos , Inmunización Pasiva/economía , Inmunoglobulinas Intravenosas/economía , Síndromes de Inmunodeficiencia/economía , Infusiones Intravenosas/economía , Inyecciones Subcutáneas/economía , Salarios y Beneficios/estadística & datos numéricos
4.
J Clin Immunol ; 32 Suppl 2: S415-20, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22730010

RESUMEN

Treatment decisions made in clinical practice, based on current guidelines, often conflict with decisions by third-party payors that restrict the ability of patients with primary immunodeficiency disease (PI) to adhere to appropriate treatment. This is seen by many physicians as potentially placing the health of patients at risk. Key treatment decisions challenged by third-party payors and discussed here include dosing, product safety, and routes of administration. Data on safety issues emphasize that IgG products are not generic drugs and each of the products currently licensed by the Food and Drug Administration (FDA) must be regarded as an individual therapy, given the products' different manufacturing processes and stabilizing ingredients. The issue of switching patients to a different product needs careful consideration as evidence shows that infusion-related adverse events in many patients are frequently related to this activity. Decisions regarding the route of therapy should also be individualized to the patient, weighing such factors as side effects, adherence with therapy, and lifestyle.


Asunto(s)
Toma de Decisiones en la Organización , Inmunoglobulinas Intravenosas/administración & dosificación , Síndromes de Inmunodeficiencia/economía , Síndromes de Inmunodeficiencia/terapia , Vías de Administración de Medicamentos , Cálculo de Dosificación de Drogas , Sustitución de Medicamentos , Humanos , Inmunoglobulinas Intravenosas/economía , Reembolso de Seguro de Salud/economía , Cumplimiento de la Medicación , Guías de Práctica Clínica como Asunto , Medicina de Precisión
5.
J Clin Immunol ; 32 Suppl 2: S410-4, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22918575

RESUMEN

Since 2005, when changes in Medicare reimbursement for IgG replacement therapy went into effect, physicians and patients with primary immunodeficiency disease (PIDD) have encountered a number of challenges to administering and receiving appropriate immunoglobulin therapy. A 2006 membership survey conducted by the American Academy of Allergy, Asthma & Immunology found that 95 % of responders thought that the health of their patients was at risk due to Medicare changes; many patient surveys also found a significant number adversely affected by these changes. Decisions critical for optimal care being made by third-party payors are often in conflict with guidelines on recommended standard of care. Many payors, for example, are dictating where infusions can occur despite evidence clearly demonstrating that choice of the site of care needs to be determined by the particular patient's circumstance and experience. Another critical issue is the lack of product availability due to the determination by payors of which IgG products appear on formularies. Patients, physicians, and payors all bring their own perspective to these issues, and finding a solution to these challenges requires balancing the needs of all three groups.


Asunto(s)
Accesibilidad a los Servicios de Salud , Inmunoglobulinas Intravenosas/economía , Síndromes de Inmunodeficiencia/economía , Síndromes de Inmunodeficiencia/terapia , Guías de Práctica Clínica como Asunto , Análisis Costo-Beneficio , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Reembolso de Seguro de Salud/estadística & datos numéricos , Medicare , Estados Unidos
6.
J Clin Immunol ; 32 Suppl 2: S423-6, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22810627

RESUMEN

Decisions by third-party payors that are restricting delivery of appropriate IgG treatment for primary immunodeficiency disease (PIDD) are summoning action from patients, physicians, and their organizations to ensure that high quality treatment remains accessible. Some of the strongest advocacy to date is from patient organizations, such as the Immune Deficiency Foundation (IDF), which strive to educate stakeholders on key issues that determine patient access to appropriate IgG treatment. These issues include the ability to choose the appropriate site of care based on a patient's experience and circumstance and greater awareness of product choice. Advocacy by physicians on these issues at the local level is needed, as are national efforts by organizations such as the American Academy of Allergy, Asthma & Immunology and their regional societies.


Asunto(s)
Síndromes de Inmunodeficiencia/economía , Defensa del Paciente/economía , Prioridad del Paciente/legislación & jurisprudencia , Toma de Decisiones en la Organización , Accesibilidad a los Servicios de Salud , Humanos , Inmunoglobulinas Intravenosas/economía , Inmunoglobulinas Intravenosas/uso terapéutico , Síndromes de Inmunodeficiencia/tratamiento farmacológico , Defensa del Paciente/legislación & jurisprudencia , Prioridad del Paciente/economía , Medicina de Precisión
7.
Allergol Immunopathol (Madr) ; 39(1): 45-51, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21167629

RESUMEN

Experts from six Latin American countries met to discuss critical issues and needs in the diagnosis and management of primary immunodeficiency diseases (PIDD). The diagnosis of PIDD is generally made following referral to an immunology centre located in a major city, but many paediatricians and general practitioners are not sufficiently trained to suspect PIDD in the first place. Access to laboratory testing is generally limited, and only some screening tests are typically covered by government health programmes. Specialised diagnostic tests are generally not reimbursed. Access to treatment varies by country reflecting differences in healthcare systems and reimbursement policies. An online PIDD Registry Programme for Latin America has been available since 2009, which will provide information about PIDD epidemiology in the region. Additional collaboration across countries appears feasible in at least two areas: a laboratory network to facilitate the diagnosis of PIDD, and educational programmes to improve PIDD awareness. In total, these collaborations should make it possible to advance the diagnosis and management of PIDD in Latin America.


Asunto(s)
Manejo de la Enfermedad , Síndromes de Inmunodeficiencia/diagnóstico , Síndromes de Inmunodeficiencia/terapia , Alergia e Inmunología/educación , Conocimientos, Actitudes y Práctica en Salud , Accesibilidad a los Servicios de Salud , Humanos , Inmunoglobulinas Intravenosas/economía , Inmunoglobulinas Intravenosas/uso terapéutico , Síndromes de Inmunodeficiencia/economía , Cobertura del Seguro , Reembolso de Seguro de Salud , América Latina , Sistema de Registros
8.
Am J Manag Care ; 25(6 Suppl): S105-S111, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31318516

RESUMEN

The introduction of human immunoglobulin (Ig) therapies 40 years ago reduced the risk of often life-threatening infections for individuals with one of several immune-related conditions known as primary immunodeficiencies. Since then, the use of Ig has expanded to numerous other conditions. However, even though less than 1% of covered lives under Medicare or commercial insurers require Ig, it is in the top 5 drug categories in terms of annual spending. The cost of Ig is directly related to the type of delivery method used and the site of care. Numerous studies attest to the efficacy and cost savings of shifting Ig to the home setting, as well as shifting patients from intravenous Ig (IVIG) to subcutaneous Ig (SCIG). In addition, surveys find that patients with primary immunodeficiencies prefer home delivery, with patient evaluations also finding a preference for SCIG. Payers have numerous options to ensure Ig is used appropriately for the right patient in the right setting. These include formulary management, site-of-care programs, education for providers and patients on the possibility of switching from IVIG to SCIG, preauthorization policies that restrict the use of Ig to certain specialties for specific indications, implementation of evidence-based coverage criteria, and shifting coverage from the medical to the pharmacy benefit.


Asunto(s)
Inmunoglobulina G/economía , Inmunoglobulina G/uso terapéutico , Inmunoglobulinas Intravenosas/economía , Inmunoglobulinas Intravenosas/uso terapéutico , Síndromes de Inmunodeficiencia/tratamiento farmacológico , Síndromes de Inmunodeficiencia/economía , Infusiones Subcutáneas/economía , Ahorro de Costo/métodos , Ahorro de Costo/estadística & datos numéricos , Humanos , Inmunoglobulina G/administración & dosificación , Medicare/economía , Medicare/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Estados Unidos
10.
Immunol Allergy Clin North Am ; 28(4): 861-74, x, 2008 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-18940579

RESUMEN

The delivery (intravenous or subcutaneous), location (home or hospital), and other factors of immunoglobulin replacement therapy are examined for cost effectiveness. Cost-minimization studies from several countries are reviewed and analyzed. A Canadian cost-minimization study is performed. Although common themes emerge, there are cost differences between the various countries.


Asunto(s)
Inmunización Pasiva/economía , Síndromes de Inmunodeficiencia/terapia , Adulto , Canadá , Preescolar , Control de Costos , Análisis Costo-Beneficio , Sistemas de Liberación de Medicamentos/economía , Sistemas de Liberación de Medicamentos/métodos , Costos de la Atención en Salud , Disparidades en Atención de Salud/economía , Humanos , Inmunización Pasiva/métodos , Síndromes de Inmunodeficiencia/economía , Síndromes de Inmunodeficiencia/inmunología , Ensayos Clínicos Controlados Aleatorios como Asunto
11.
Immunol Allergy Clin North Am ; 28(4): 821-32, ix, 2008 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-18940576

RESUMEN

This review of the currently available literature from more than two decades of clinical experience with self-infusions of immunoglobulin at home provides evidence to support the feasibility, safety, and efficacy in all age groups. Self-infusions at home not only increase patient confidence and their understanding of the immune deficiency but also contribute to the improvement of health-related quality of life. Such home therapy programs should be encouraged, and wherever possible, experienced centers should extend their services to include patients who require immunoglobulin therapy for immunomodulation. Home therapy programs play an important role in long-term health outcome.


Asunto(s)
Terapia de Infusión a Domicilio/métodos , Inmunización Pasiva/métodos , Síndromes de Inmunodeficiencia/terapia , Terapia de Infusión a Domicilio/economía , Terapia de Infusión a Domicilio/psicología , Terapia de Infusión a Domicilio/tendencias , Humanos , Inmunización Pasiva/economía , Inmunización Pasiva/psicología , Inmunización Pasiva/tendencias , Síndromes de Inmunodeficiencia/economía , Educación del Paciente como Asunto , Guías de Práctica Clínica como Asunto , Desarrollo de Programa/economía , Desarrollo de Programa/métodos , Calidad de Vida
12.
Immunol Res ; 38(1-3): 51-4, 2007.
Artículo en Inglés | MEDLINE | ID: mdl-17917009

RESUMEN

Dr. Robert A. Good and the March of Dimes Birth Defects Foundation maintained a close association for a quarter century in the fight against immunodeficiency diseases. The March of Dimes, whose mission is to prevent birth defects, premature birth, and infant mortality, awarded an initial grant to Dr. Good in 1960 to conduct basic clinical and experimental studies on arthritis and collagen diseases. By 1966, this support broadened to include Dr. Good's research on agammaglobulinemia, ataxia telangiectasia, Chediak-Higashi disease, and Wiskott-Aldrich syndrome. Dr. Good led three historic March of Dimes conferences on immunodeficiency and, in 1968, conducted the first bone marrow transplant to correct an immunological birth defect, memorialized by the March of Dimes in its educational film, Decision (1970). March of Dimes grants to Dr. Good for his research in cellular engineering to genetically correct the defined birth defects approached $1 million for the period 1960-1985.


Asunto(s)
Fundaciones/historia , Síndromes de Inmunodeficiencia/historia , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Síndromes de Inmunodeficiencia/economía , Estados Unidos
15.
Clin Exp Immunol ; 150(3): 437-41, 2007 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-17956584

RESUMEN

Intravenous immunoglobulin (IVIg) replacement therapy is the standard of care for patients with primary humoral immunodeficiencies. This study evaluated differences in infusion time between a 10% IVIg ready-to-use solution and a 6% IVIg lyophilized product and addressed potential cost implications. After receiving in-hospital treatment with 6% IVIg lyophilized solution for at least 6 months, 14 patients with humoral immunodeficiency without anti-IgA antibodies received five successive infusions with 10% IVIg ready-to-use solution. Data on infusion times were collected during the last two infusions of each IVIg product when maximum infusion rates had been reached. The median infusion time was reduced from 104.4 min with the 6% IVIg lyophilized solution to 51.0 min with the 10% IVIg ready-to-use solution (51% reduction), with corresponding median maximum infusion rates of 4.1 ml/kg/h and 5.9 ml/kg/h, respectively. Median gammaglobulin (IgG) trough levels were 7.1 g/l for the 6% IVIg lyophilized solution and 7.9 g/l for the 10% IVIg ready-to-use solution. Fewer adverse events were observed after infusing with 10% IVIg ready-to-use solution compared with 6% IVIg lyophilized preparation. We conclude that the 10% IVIg ready-to-use solution was well tolerated by most patients and reduced the median infusion time by 51% compared with a 6% lyophilized preparation of IVIg. The reduced bed occupancy and nursing time associated with a reduced infusion time, together with the elimination of a reconstitution step, were estimated to provide a cost-saving of 59.42 euros per patient per infusion. Thus, this product has the potential to reduce overall costs of IVIg treatment. Reduced infusion time is also likely to improve patients' quality of life.


Asunto(s)
Inmunoglobulinas Intravenosas/economía , Inmunoglobulinas Intravenosas/uso terapéutico , Síndromes de Inmunodeficiencia/terapia , Adulto , Anciano , Anciano de 80 o más Años , Química Farmacéutica , Análisis Costo-Beneficio , Costos de los Medicamentos/estadística & datos numéricos , Femenino , Liofilización , Humanos , Inmunoglobulina G/sangre , Inmunoglobulinas Intravenosas/efectos adversos , Síndromes de Inmunodeficiencia/economía , Síndromes de Inmunodeficiencia/inmunología , Infusiones Intravenosas , Masculino , Persona de Mediana Edad , Países Bajos , Factores de Tiempo
17.
PLoS One ; 12(4): e0175867, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28448570

RESUMEN

BACKGROUND: In addition to the deleterious effect on health, there is considerable economic and psychosocial morbidity associated with primary immunodeficiency diseases (PID). Also, the cost of a late diagnosis frequently results in a heavy disease burden on the patient. The objective of this study was to collect and analyze data on patients with PID in the state of Guanajuato in Mexico, to indirectly estimate the burden of the disease. METHODS: An observational, longitudinal, and comparative study was conducted. A total of 44 patients were included and grouped according to the updated classification of PID. RESULTS: The median time elapsed from the onset of symptoms to the reference and diagnosis by a tertiary hospital was of 2.17 (IQR = 6.44) years. Before diagnosis, the number of hospitalizations/year per patient was 0.86 (IQR = 2.28), the number of visit to emergency room/year per patient was 0.92 (IQR = 1.77), the number of doctor's visits/year per patient was 15 (IQR = 11.25), whereas the school/work absence days per patient were reported in 52.72 (IQR = 56.35) days per year. After diagnosis, 20 patients (45.45%) received IVIG replacement therapy, and all of them presented a significant improvement (p <0.05) in all the mentioned variables. Characteristically, even when patients with PID received IVIG, there was still an important disease burden when comparing them against healthy controls. Complications secondary to PID were detected in 19 patients (43.18%). The reported overall mortality rate was 6.82% (n = 3). CONCLUSIONS: We were able to indirectly estimate an important disease burden in patients with PID; which is considered to be preventable, at least in part, with effective interventions like health planning, research, collaboration with primary care providers, and generation of policies and practices, in order to improve the quality of life and care of families with PID.


Asunto(s)
Costo de Enfermedad , Síndromes de Inmunodeficiencia/economía , Adolescente , Adulto , Estudios de Casos y Controles , Niño , Preescolar , Servicio de Urgencia en Hospital , Femenino , Hospitalización , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Síndromes de Inmunodeficiencia/diagnóstico , Síndromes de Inmunodeficiencia/tratamiento farmacológico , Síndromes de Inmunodeficiencia/mortalidad , Lactante , Estudios Longitudinales , Masculino , México , Tasa de Supervivencia , Centros de Atención Terciaria , Adulto Joven
18.
J Manag Care Spec Pharm ; 23(4): 400-406, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28345437

RESUMEN

BACKGROUND: Patients with primary immune deficiency (PID) often require immunoglobulin G (IgG, commonly referred to as Ig) replacement therapy to prevent infections and associated comorbidities. Ig therapy can be given either through intravenous or subcutaneous routes, and both can be done in the home setting. There is limited information available on the real-world diagnosis, management, and outcomes of this patient population, given the variable disease presentation and treatment options. The Immunoglobulin Diagnosis, Evaluation, and key Learnings (IDEaL) Patient Registry is designed to capture nursing, pharmacy, and patient-reported data for patients receiving Ig at home. OBJECTIVES: To (a) present a real-world population of patients with PID who have received Ig at home and (b) examine how differences in administration, dosing, and insurance affect health and quality-of-life outcomes in these patients. METHODS: As of July 2015, 383 patients receiving Ig therapy from Coram/CVS specialty infusion services, across multiple disease states, signed consent forms and enrolled in the IDEaL Patient Registry. Patients' referral paperwork, including lab values, and standard of care nursing and pharmacy follow-up forms were collected. Patients were mailed quality-of-life surveys at the time of enrollment and every 6 months after their enrollment. RESULTS: The most common diagnosis (78%) in these PID patients was common variable immunodeficiency (CVID). For Ig-naive adult patients, the average age at the start of treatment was 59 years. For pediatric patients, average age at start of treatment was 9 years. A majority of these PID patients (80%) received subcutaneous Ig (SCIg) at home, and 20% received intravenous Ig (IVIg). The average SCIg dose was 10 grams per week, or 130 mg per kg, and the average IVIg dose was 36 grams every 4 weeks, or 472 mg per kg. In the IVIg patient population, 34% had a dose or frequency change while on treatment, while 30% of the SCIg patients had a dose or frequency change. Patient-reported health and quality-of-life scores were generally positive. Route of administration did not affect patient perception of cost (P = 0.171), but whether the patient had private or government-backed health care did affect perception of cost (P = 0.036). CONCLUSIONS: For a disease state with an extremely variable presentation, data from the IDEaL Patient Registry provides further insights into the real-world clinical and diagnostic characteristics of this population, as well as dosing and treatment outcomes of home administration of Ig therapy. The majority of patients received SCIg infusions. SCIg dosing was on the lower end of the recommended mg per kg dose range, while IVIg patients were more in the middle of the recommended dose range. Patient outcomes on treatment were correlated with baseline status, suggesting that earlier detection and treatment of primary immune deficiencies may be critical in achieving beneficial outcomes on Ig therapy. DISCLOSURES: No outside funding supported this study. Seidu was compensated by Coram Clinical Trials for acting as primary investigator and reviewing data. Study concept and design were contributed by all the authors. Kearns, Kristofek, and Kiles collected the data, and data interpretation was performed by Kearns, Seidu, and Kristofek, along with Bolgar. The manuscript was written and revised primarily by Kearns, along with Kristofek, Bolgar, and Seidu.


Asunto(s)
Servicios de Atención de Salud a Domicilio/organización & administración , Inmunoglobulina G/administración & dosificación , Inmunoglobulina G/uso terapéutico , Síndromes de Inmunodeficiencia/tratamiento farmacológico , Adolescente , Adulto , Anciano , Niño , Femenino , Servicios de Atención de Salud a Domicilio/economía , Terapia de Infusión a Domicilio , Humanos , Inmunoglobulinas Intravenosas/administración & dosificación , Inmunoglobulinas Intravenosas/uso terapéutico , Síndromes de Inmunodeficiencia/economía , Síndromes de Inmunodeficiencia/psicología , Masculino , Cumplimiento de la Medicación , Persona de Mediana Edad , Calidad de Vida , Sistema de Registros , Resultado del Tratamiento
19.
Rev Med Interne ; 27(12): 924-6, 2006 Dec.
Artículo en Francés | MEDLINE | ID: mdl-17011081

RESUMEN

BACKGROUND: Intravenous (IV) and subcutaneous (SC) immunoglobulin (Ig) administration is a safe and an efficacious treatment in patients with IgG deficiency. Home administration of IV Ig and SC Ig has recently been approved in France. Most of the patients treated in hospital ask for home treatment. Some patients prefer monthly IV administration, others weekly SC administration. MATERIAL AND METHODS: We evaluated in details the cost of both of these practices. We currently use electric pumps for both IV and SC administration which are fixed to the patient giving complete freedom and mobility. RESULTS: For 20 g administrated per 4 week, the total cost of home treatment is 1,518 euro with SC Ig and 1,033 euro with IV Ig. For 40 g administrated per 4 week, the total cost of home treatment is 2,507 euro to 2,729 euro with SC Ig and 2,034 euro with IV Ig. The difference is mainly explained by the cost of renting the electric pumps and by the cost of furniture for SC administration. The choice of home Ig substitution must be given to all patient receiving treatment in hospital. CONCLUSIONS: Home IV and home SC perfusions are two possible options each different with there own advantages and disadvantages. The cost of each procedure must be known by the medical staff.


Asunto(s)
Servicios de Atención de Salud a Domicilio/economía , Inmunoglobulinas Intravenosas/economía , Inmunoglobulinas/administración & dosificación , Inmunoglobulinas/economía , Síndromes de Inmunodeficiencia/tratamiento farmacológico , Síndromes de Inmunodeficiencia/economía , Análisis Costo-Beneficio , Francia , Humanos , Inyecciones Subcutáneas/economía
20.
Immunol Res ; 64(3): 736-53, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-26802037

RESUMEN

Primary immunodeficiencies (PI) are defects of the immune system that cause severe, sometimes life-threatening, infections if not diagnosed and treated appropriately. Many patients with PI are undiagnosed, under-diagnosed, or misdiagnosed. To raise awareness and assure earliest diagnosis, appropriate treatment, and proper care management, the Jeffrey Modell Foundation (JMF) implemented a physician education and public awareness program beginning in 2003. Data are requested annually from physician experts within the Jeffrey Modell Centers Network (JMCN), consisting of 602 expert physicians, at 253 academic institutions, in 206 cities, and 84 countries spanning six continents. Center Directors reported on patients' specific PI defects and treatment modalities including immunoglobulins, transplantation, and gene therapy as well as data on gender and age. Center Directors also provided physician-reported patient outcomes as well as pre- and post-diagnosis differences. Costs were assigned to these factors. In collaboration with the Network, JMF advocated, funded, and implemented population-based newborn screening for severe combined immunodeficiency and T cell lymphopenia, covering 96.2 % of all newborns in the US. Finally, 21 JMF Centers participated in a polio surveillance study of patients with PI who either received or have been exposed to the oral polio vaccine. These initiatives have led to an overall better understanding of the immune system and will continue to improve quality of life for those with PI.


Asunto(s)
Síndromes de Inmunodeficiencia/epidemiología , Sector Privado , Vacunas Virales/inmunología , Costos y Análisis de Costo , Diagnóstico Precoz , Educación Médica , Femenino , Fundaciones , Humanos , Síndromes de Inmunodeficiencia/diagnóstico , Síndromes de Inmunodeficiencia/economía , Recién Nacido , Masculino , Tamizaje Neonatal , Educación del Paciente como Asunto , Evaluación del Resultado de la Atención al Paciente , Estados Unidos/epidemiología
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