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...

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Veröffentlicht in:The journal of allergy and clinical immunology in practice (Cambridge, MA) MA), 2019-01, Vol.7 (1), p.328-330
Hauptverfasser: Javaud, Nicolas, Bouillet, Laurence, Rabetrano, Hasina, Bitoun, Alexandre, Launay, David, Lapostolle, Frederic, Reuter, Paul-Georges, Martin, Ludovic, Vicaut, Eric, Fain, Olivier, Adnet, Frederic, Durand-zaleski, Isabelle, Floccard, Bernard, Gompel, Anne, Sobel, Alain, Boccon-Gibod, Isabelle, Coppere, Brigitte, Kanny, Gisele
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container_title The journal of allergy and clinical immunology in practice (Cambridge, MA)
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creator Javaud, Nicolas
Bouillet, Laurence
Rabetrano, Hasina
Bitoun, Alexandre
Launay, David
Lapostolle, Frederic
Reuter, Paul-Georges
Martin, Ludovic
Vicaut, Eric
Fain, Olivier
Adnet, Frederic
Durand-zaleski, Isabelle
Floccard, Bernard
Gompel, Anne
Sobel, Alain
Boccon-Gibod, Isabelle
Coppere, Brigitte
Kanny, Gisele
description 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
doi_str_mv 10.1016/j.jaip.2018.05.036
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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 workdays lost 55 ± 87 Average total cost during the second year for patients alive 10,599 ± 16,823 0-24 mo N = 200 Average yearly total cost per patient 10,244 ± 17,365 Patients receiving long-term prophylaxis N = 120 12,019 ± 18,845 Patients without long-term prophylaxis N = 80 7,637 ± 14,668 Table II Health economics (resource use and costs) outcomes during the 2 years follow-up</description><identifier>ISSN: 2213-2198</identifier><identifier>EISSN: 2213-2201</identifier><identifier>DOI: 10.1016/j.jaip.2018.05.036</identifier><identifier>PMID: 29936190</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Abdomen ; 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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 workdays lost 55 ± 87 Average total cost during the second year for patients alive 10,599 ± 16,823 0-24 mo N = 200 Average yearly total cost per patient 10,244 ± 17,365 Patients receiving long-term prophylaxis N = 120 12,019 ± 18,845 Patients without long-term prophylaxis N = 80 7,637 ± 14,668 Table II Health economics (resource use and costs) outcomes during the 2 years follow-up</description><subject>Abdomen</subject><subject>Adult</subject><subject>Androgens</subject><subject>Angioedema</subject><subject>Angioedemas, Hereditary - diagnosis</subject><subject>Angioedemas, Hereditary - drug therapy</subject><subject>Angioedemas, Hereditary - epidemiology</subject><subject>Cancer</subject><subject>Children</subject><subject>Complement C1 Inhibitor Protein - therapeutic use</subject><subject>Costs and Cost Analysis</subject><subject>Diabetes mellitus</subject><subject>Dyslipidemia</subject><subject>Edema</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>France - epidemiology</subject><subject>Health care policy</subject><subject>Heart diseases</subject><subject>Home Care Services</subject><subject>Hospitalization - statistics &amp; numerical data</subject><subject>Humans</subject><subject>Male</subject><subject>Mental disorders</subject><subject>Middle Aged</subject><subject>Patient admissions</subject><subject>Patients</subject><subject>Population studies</subject><subject>Progestin</subject><subject>Prophylaxis</subject><subject>Prospective Studies</subject><subject>Questionnaires</subject><subject>Renal failure</subject><subject>Self Care</subject><subject>Self-administration</subject><subject>Socioeconomic Factors</subject><subject>Stroke</subject><subject>Substance abuse treatment</subject><subject>Tobacco</subject><issn>2213-2198</issn><issn>2213-2201</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFq3DAQhkVpaEKSF-ihCHLpZd2RZEt26KUsSVMI9JJcehHyaLaVsS1X8hby9tGySQ89VJeRxPf_DB9j7wVUAoT-NFSDC0slQbQVNBUo_YadSSnURpa_t6930bWn7DLnAcpphYEa3rFT2XVKiw7O2I87SuTD6tITd_PPEMnT5K75dgxzQDfyJVGmeXVriHMhPM8RC4VxjlNAjjGvPO64BOC3iWb8xZfClkS-YCc7N2a6fJnn7PH25mF7t7n__vXb9sv9BlVbrxttvK8b42V5GYe9b4RuJWqjdzWCN6qXhlD22Nei16R0r4zsWhC-Mdi3Wp2zj8feJcXfe8qrnUJGGkc3U9xnK6HpoJaiEQW9-gcd4j7NZTsrhRbQKKFUoeSRwhRzTrSzSwpTMWQF2IN8O9iDfHuQb6GxRX4JfXip3vcT-b-RV9UF-HwEqLj4EyjZjMUTFvuJcLU-hv_1PwMKZ5P8</recordid><startdate>201901</startdate><enddate>201901</enddate><creator>Javaud, Nicolas</creator><creator>Bouillet, Laurence</creator><creator>Rabetrano, Hasina</creator><creator>Bitoun, Alexandre</creator><creator>Launay, David</creator><creator>Lapostolle, Frederic</creator><creator>Reuter, Paul-Georges</creator><creator>Martin, Ludovic</creator><creator>Vicaut, Eric</creator><creator>Fain, Olivier</creator><creator>Adnet, Frederic</creator><creator>Durand-zaleski, Isabelle</creator><creator>Floccard, Bernard</creator><creator>Gompel, Anne</creator><creator>Sobel, Alain</creator><creator>Boccon-Gibod, Isabelle</creator><creator>Coppere, Brigitte</creator><creator>Kanny, Gisele</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201901</creationdate><title>Hereditary angioedema: Clinical presentation and socioeconomic cost of 200 French patients</title><author>Javaud, Nicolas ; Bouillet, Laurence ; Rabetrano, Hasina ; Bitoun, Alexandre ; Launay, David ; Lapostolle, Frederic ; Reuter, Paul-Georges ; Martin, Ludovic ; Vicaut, Eric ; Fain, Olivier ; Adnet, Frederic ; Durand-zaleski, Isabelle ; Floccard, Bernard ; Gompel, Anne ; Sobel, Alain ; Boccon-Gibod, Isabelle ; Coppere, Brigitte ; Kanny, Gisele</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-67dd457d23847acbd51682c676f4c0d73b27ec2bcb41b6e36b3729801d57cb863</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdomen</topic><topic>Adult</topic><topic>Androgens</topic><topic>Angioedema</topic><topic>Angioedemas, Hereditary - diagnosis</topic><topic>Angioedemas, Hereditary - drug therapy</topic><topic>Angioedemas, Hereditary - epidemiology</topic><topic>Cancer</topic><topic>Children</topic><topic>Complement C1 Inhibitor Protein - therapeutic use</topic><topic>Costs and Cost Analysis</topic><topic>Diabetes mellitus</topic><topic>Dyslipidemia</topic><topic>Edema</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>France - epidemiology</topic><topic>Health care policy</topic><topic>Heart diseases</topic><topic>Home Care Services</topic><topic>Hospitalization - statistics &amp; 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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 workdays lost 55 ± 87 Average total cost during the second year for patients alive 10,599 ± 16,823 0-24 mo N = 200 Average yearly total cost per patient 10,244 ± 17,365 Patients receiving long-term prophylaxis N = 120 12,019 ± 18,845 Patients without long-term prophylaxis N = 80 7,637 ± 14,668 Table II Health economics (resource use and costs) outcomes during the 2 years follow-up</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29936190</pmid><doi>10.1016/j.jaip.2018.05.036</doi><tpages>3</tpages></addata></record>
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identifier ISSN: 2213-2198
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2213-2201
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source MEDLINE; Alma/SFX Local Collection
subjects Abdomen
Adult
Androgens
Angioedema
Angioedemas, Hereditary - diagnosis
Angioedemas, Hereditary - drug therapy
Angioedemas, Hereditary - epidemiology
Cancer
Children
Complement C1 Inhibitor Protein - therapeutic use
Costs and Cost Analysis
Diabetes mellitus
Dyslipidemia
Edema
Female
Follow-Up Studies
France - epidemiology
Health care policy
Heart diseases
Home Care Services
Hospitalization - statistics & numerical data
Humans
Male
Mental disorders
Middle Aged
Patient admissions
Patients
Population studies
Progestin
Prophylaxis
Prospective Studies
Questionnaires
Renal failure
Self Care
Self-administration
Socioeconomic Factors
Stroke
Substance abuse treatment
Tobacco
title Hereditary angioedema: Clinical presentation and socioeconomic cost of 200 French patients
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