Economic evaluation of intravenous immune globulin therapy for Kawasaki syndrome

Terry P. Klassen, Peter C. Rowe, Amiram Gafni

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To determine the costs and clinical outcomes of three alternative treatments of the acute phase of Kawasaki syndrome: aspirin alone; low doses of intravenously administered immune globulin (IVIG-LD), 400 mg/kg per dose for 4 days; and high doses of intravenously administered immune globulin (IVIG-HD), 2.0 gm/kg for one dose. Design: A model was developed that assumed the inclusion of 100 patients with acute Kawasaki syndrome in each treatment option. Costs were valued by using the Chedoke-McMaster Corporate Cost Model in 1992 Canadian dollars. Clinical outcome, based on the published literature, was measured by the prevalence of coronary artery dilation at 7 weeks from the diagnosis of Kawasaki syndrome. Results: For every 100 patients with Kawasaki syndrome, the cost was reduced by $323,400 when aspirin therapy alone was changed to VIG-HD therapy and 14 cases of coronary artery dilation were therepy prevented. When IVIG-HD therapy was compared with IVIG-LD therapy, the cost was reduced by $118,200 because two cases of coronary artery aneurysm were prevented. This latter result was sensitive to the duration of hospitalization, with IVIG-HD costing $8500 more for every 100 patients than IVIG-LD when it was assumed that both groups were hospitalized for 5 days, an unlikely occurrence. Conclusions: Treatment with IVIG-HD for Kawasaki syndrome is preferred because it results in both lower costs and lower rates of coronary artery dilation.

Original languageEnglish (US)
Pages (from-to)538-542
Number of pages5
JournalThe Journal of pediatrics
Volume122
Issue number4
DOIs
StatePublished - Apr 1993

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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