Humanistic and Economic Burden of IgA Nephropathy: Systematic Literature Reviews and Narrative Synthesis
Topics: Nephrology IgAN HEOR RWE
Jhaveri KD, Bensink ME, Bunke M et al.
10.1007/s41669-023-00415-0
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
Footnotes
CAD, Canadian dollars; HRQoL, healthcare-related quality of life; HRU, healthcare resource utilization; QoL, quality of life.
- Jhaveri KD et al. Pharmacoecon Open. 2023;7(5):709-722.
- Wyatt RJ, Julian BA. N Engl J Med. 2013;368(25):2402-2414.
- Yeo SC et al. Pediatr Nephrol. 2018;33(5):763-777.
- Artom M et al. Kidney Int. 2014;86(3):497-505.
- Golestaneh L et al. Am J Manag Care. 2017;23(10 Suppl):S163-S172.
- Baek HS et al. Nephrology (Carlton). 2018;23(8):764-770.
- Marsh K et al. The Patient. 2021;14(6):837-847.
- Mizerska-Wasiak M et al. Arch Med Sci. 2021;17(1):84-91.
- Zhao Y et al. J Int Med Res. 2020;48(1):300060519898008.
- Babour S et al. Nephrol Dial Transplant. 2018;33(4):626-634.
- Hiragi S et al. BMC Med Inform Decis Mak. 2018;18(1):94.
- Ishida M et al. Value Health Reg Issues. 2022;29:8-15.
- Li J et al. Nephrol Dial Transplant. 2018;33(12):2173-2181.
- Carlassara L et al. MO898 Nephrol Dial Transplant. 2021;36(Suppl. 1), gfab100.0023.
MA-DS-24-0036 | September 2024