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Humanistic and Economic Burden of IgA Nephropathy: Systematic Literature Reviews and Narrative Synthesis

Journal article
Published on April 27, 2023

Topics: Nephrology IgAN HEOR RWE

Contributors:
Jhaveri KD, Bensink ME, Bunke M et al.
Name of Journal:
PharmacoEconomics – Open


View Publication
DOI:
10.1007/s41669-023-00415-0
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Home » Publications » Humanistic and Economic Burden of IgAN

Summary

The high humanistic and economic burden of IgA nephropathy1

Background

IgA nephropathy is an immune-mediated disease that leads to proteinuria, loss of glomerular filtration rate, and ultimately kidney failure.2,3 The physical limitations and fatigue of kidney failure impose a high burden on patients,4 and treatments for patients who progress to kidney failure – dialysis and kidney transplants – are costly and have profound impacts on quality of life (QoL).5,6


Aims and approach

The two systematic literature reviews presented summarized the following in relation to IgA nephropathy1:

  • Impacts on healthcare-related quality of life (HRQoL)
  • Economic costs/healthcare resource utilization (HRU)

Findings

Three studies on the humanistic impact of IgA nephropathy were identified1

Marsh K et al. The Patient Patient-Cent Outcomes Res. 2021

A study of 40 patients in the US and China found treatment-decision making to impact QoL; patients placed the greatest value on avoiding dialysis treatment.7 Similar weight was given to short-term QoL improvements and avoiding infections.7

Mizerska-Wasiak M et al. Arch Med Sci. 2021

Another survey with IgA nephropathy (n=51) evaluated HRQoL in Poland.8 Participants rated their psychological well-being as worse than healthy comparators.8 Perceived emotional strength was higher for study participants, and a lower intensity of expressed anger was reported compared with a healthy reference population.8

Zhao Y et al. J Int Med Res. 2020

An observational study in China found that patients who completed a 6-month physical activity program (n=108) had lower levels of severe depression compared with counterparts in a control group.9

Five publications on the economic burden of IgA nephropathy were identified1

Babour S et al. Nephrol Dial Transplant. 2018

Barbour et al. reported that the per-patient cost of immunosuppressive medication in IgA nephropathy increased from 158 CAD in 2000 to 221 in 2013, with prednisone being the most common treatment.10

Hiragi S et al. BMC Med Inform Decis Mak. 2018

A comparison of disease grade- and kidney function-based costing models of immunosuppressive therapy found that the latter resulted in a greater number of life years and lower costs (78.8 vs. 76.35 years and $122,990 vs $199,980, respectively).11

Ishida M et al. Value Health Reg Issues. 2022

Ishida et al. reported a cost analysis comparing novel biomarkers (galactose-deficient IgA1, IgA1 antibodies and immune complexes) with renal biopsy alone.12 Over a 40-year period, the novel biomarker approach was predicted to have lower costs per patient ($291,000 vs. $312,000).12

Li J et al. Nephrol Dial Transplant. 2018

A national database study reported costs for a large cohort of hospitalized IgA nephropathy patients in China (n=11,569).13 Median costs were 8,000 yuan per patient (1,120 USD), and median length of stay was 10 days.13

Carlassara L et al. MO898 Nephrol Dial Transplant. 2021

An additional study was identified in a conference abstract, but minimal data were available.14


Key takeaway

The data from these studies, collected with different methodologies and from diverse populations, suggest that IgA nephropathy has a high humanistic impact and substantial economic burden.1 With few studies identified, there is a need for further research to better characterize the burden of disease and understand potential benefits of novel treatments.1




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Footnotes

CAD, Canadian dollars; HRQoL, healthcare-related quality of life; HRU, healthcare resource utilization; QoL, quality of life.

  1. Jhaveri KD et al. Pharmacoecon Open. 2023;7(5):709-722.
  2. Wyatt RJ, Julian BA. N Engl J Med. 2013;368(25):2402-2414.
  3. Yeo SC et al. Pediatr Nephrol. 2018;33(5):763-777.
  4. Artom M et al. Kidney Int. 2014;86(3):497-505.
  5. Golestaneh L et al. Am J Manag Care. 2017;23(10 Suppl):S163-S172.
  6. Baek HS et al. Nephrology (Carlton). 2018;23(8):764-770.
  7. Marsh K et al. The Patient. 2021;14(6):837-847.
  8. Mizerska-Wasiak M et al. Arch Med Sci. 2021;17(1):84-91.
  9. Zhao Y et al. J Int Med Res. 2020;48(1):300060519898008.
  10. Babour S et al. Nephrol Dial Transplant. 2018;33(4):626-634. 
  11. Hiragi S et al. BMC Med Inform Decis Mak. 2018;18(1):94.
  12. Ishida M et al. Value Health Reg Issues. 2022;29:8-15.
  13. Li J et al. Nephrol Dial Transplant. 2018;33(12):2173-2181.
  14. Carlassara L et al. MO898 Nephrol Dial Transplant. 2021;36(Suppl. 1), gfab100.0023.

MA-DS-24-0036 | September 2024