Hereditary angioedema: Clinical presentation and socioeconomic cost of 200 French patients

Two studies suggest that HAE may lead to substantial costs and burden, associated with attack severity.2,3 Lumry et al4 reported reasonably high health-related quality-of-life (HRQOL) scores for patients included in the Clinical Studies for Optimal Management of Preventing Angioedema with Low-Volume Subcutaneous C1-Inhibitor (C1-INH) Replacement Therapy trial. The outcomes of interest were total direct medical costs, which included hospital admissions, drug use, emergency department (ED) visits, home nurse or physician visits, emergency service interventions, transportation covered by the French statutory health insurance, and consultations. Another difference was a fewer rate of ED visits and hospitalizations in our study. [...]our patients were already integrated into an expert HAE network with therapeutic education programs. Characteristic of patients N = 200 Demographic characteristics Female sex, n (%) 74 (37) Age (y), median (Q1-Q3) 40 (29-54) Coexisting conditions, n (%) Hypertension 20 (10) Tobacco use 19 (10) Diabetes 9 (5) Dyslipidemia 18 (9) Chronic heart failure 1 (0.5) Chronic renal failure 1 (0.5) Stroke 2 (1) Cancer 10 (5) Psychiatric disorders 0 (0) Type of HAE, n (%) HAE type I 164 (82) HAE type II 14 (7) FXII-HAE 22 (11) History of angioedema, n (%) Number of families included 153 (77) Patients with at least 1 HAE sick parent 139 (70) Patients with at least 1 children 132 (66) Patients with at least 1 HAE sick children 119 (60) Patients with at least 1 HAE sick sibling 96 (48) Years since diagnosis, median (Q1-Q3) 14 (5-29) Long-term and available emergency treatment at baseline, n (%) Androgen 63 (32) Tranexamic acid 39 (20) Progestin 41 (21) Icatibant 149 (75) C1-INH 53 (27) Nurse-led formation on self-administration of specific therapy 185 (93) Table I Baseline characteristics of the study population Average cost ± SD per patient (€) N = 200 Patients completed the 0- to 12-mo follow-up N = 199 Drug cost 10,038 ± 10,334 ED visits + transportation 99 ± 25 Consultation GP/specialist 26 ± 10 Nurse 10 ± 2 Hospital cost 122 ± 176 Total average health care costs 10,296 ± 17,828 Average compensation for workdays lost 54 ± 89 Average total cost during the first year 10,350 ± 17,968 Patients completed the 12- to 24-mo follow-up N = 194 Drug cost 10,287 ± 8,260 ED visits + transportation 101 ± 24 Consultation GP/specialist 27 ± 10 Nurse 10 ± 2 Hospital cost 118 ± 180 Total average health care costs 10,544 ± 17,525 Average compensation for workday