Cost-Analysis of Chronic Idiopathic Urticaria Disease

Abstract

Objectives: Chronic idiopathic (or spontaneous) urticaria (CIU) is estimated to occur in 0.3% of the general population in Turkey. Although the burden of the disease is substantial for the payer, there has been no cost-analysis performed in our country. The purposes of this study are to determine the resources and costs related to the diagnosis and treatment of patients with CIU, and to estimate the annual economic burden to the Social Security Institution (SGK). MethOds: Delphi technique was applied to determine the type and the amount of resources used in different stages of CIU defined as mild or moderate to severe based on physicians clinical assessment. The Delphi method solicits the opinion of an expert panel through a carefully designed questionnaire which in this case included questions on: epidemiology, diagnosis, treatment of symptoms and angioedema, adverse events, follow-up visits, hospital and emergency service admissions. The responses were analysed and discussed in a face to face meeting followed by consensus building steps. Unit of resources used for different CIU severity levels were determined from expert opinion. Unit costs of resources used in outpatient clinics were obtained from SGK's Reimbursement Guideline-List of Procedure Fees Per Service. Results: Hospitalizations, emergency admissions, outpatient visits and treatments, are the key cost drivers in the management of CIU The annual cost per patient is calculated to be 725.36 Turkish Liras (TL) for mild CIU, 1.322,61 TL for moderate CIU and 2,478.75 TL for severe CIU. The total annual cost of CIU to SGK is estimated to be 262 million TL in 2014. cOnclusiOns: This is the first study that aims to estimate the resource utilisation and cost burden of CIU in Turkey by using the Delphi technique. Cost effective treatment of CIU is an unmet need given the heavy burden to SGK identified by the Delphi Panel.