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Original ArticleOpen Access
A Cost-Benefit Analysis of Intravenous Immunoglobulin Treatment in Children with Kawasaki Disease
MD SA 
,
Chotivitayatarakorn P ,
Lertsapcharoen P ,
Khongphatthanayothin A ,
Thisyakorn C
,
Chotivitayatarakorn P ,
Lertsapcharoen P ,
Khongphatthanayothin A ,
Thisyakorn C To determine the long-term cost-benefit of intravenous immunoglobulin (IVIG) treatment in
Children with Kawasaki Disease (KD), a model was made to compare the total cost for management
of these children with and without the use of IVIG. Long-term (10-21 years) follow-up of 594 KD
patients treated in the pre-IVIG era reported by Kato, et al. was used to calculate cost using previous
cost studies from Chulalongkom Hospital. Reduction of CAA from 25 per cent to 4 per cent with IVIG
treatment was assumed based on previous published data. Total cost was slightly lower for the non-
IVIG treatment group compared to the IVIG treatment group (33,451, 129 baht
vs
35,001,195 baht) for
the duration of follow-up in Kato's model. Cost per effectiveness analysis showed more effectiveness
in the IVIG treatment group (359,576 baht
vs
383,614 baht). Net cost analysis similarly demonstrated
lower costs in the IVIG treatment group (25,365,215 baht
vs
33,451,129 baht). Incremental cost-effec-
tiveness analysis demonstrated supplementary costs of 13,663 baht for one case in the reduction of
coronary involvement and 387,517 baht for one life saved in the IVIG-treated group. Estimation of
total costs for follow-up and treatment for healthy life (until 60 years old) was more expensive in the
non-IVIG treatment than the IVIG treated group (75,482,803 baht
vs
29,883,833 baht). The authors
conclude that treatment of all KD cases in Thailand with IVIG is likely to result in lower cost and better
outcome when compared to no treatment with the IVIG policy.
Key word
: Kawasaki Disease, Intravenous Immunoglobulin, Coronary Artery Aneurysm, Cost
Children with Kawasaki Disease (KD), a model was made to compare the total cost for management
of these children with and without the use of IVIG. Long-term (10-21 years) follow-up of 594 KD
patients treated in the pre-IVIG era reported by Kato, et al. was used to calculate cost using previous
cost studies from Chulalongkom Hospital. Reduction of CAA from 25 per cent to 4 per cent with IVIG
treatment was assumed based on previous published data. Total cost was slightly lower for the non-
IVIG treatment group compared to the IVIG treatment group (33,451, 129 baht
vs
35,001,195 baht) for
the duration of follow-up in Kato's model. Cost per effectiveness analysis showed more effectiveness
in the IVIG treatment group (359,576 baht
vs
383,614 baht). Net cost analysis similarly demonstrated
lower costs in the IVIG treatment group (25,365,215 baht
vs
33,451,129 baht). Incremental cost-effec-
tiveness analysis demonstrated supplementary costs of 13,663 baht for one case in the reduction of
coronary involvement and 387,517 baht for one life saved in the IVIG-treated group. Estimation of
total costs for follow-up and treatment for healthy life (until 60 years old) was more expensive in the
non-IVIG treatment than the IVIG treated group (75,482,803 baht
vs
29,883,833 baht). The authors
conclude that treatment of all KD cases in Thailand with IVIG is likely to result in lower cost and better
outcome when compared to no treatment with the IVIG policy.
Key word
: Kawasaki Disease, Intravenous Immunoglobulin, Coronary Artery Aneurysm, Cost
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