Balp M, Abuzakouk M, Berard F, Canonica GW, Gimenez-Arnau A, Hollis K, Khalil S, Knulst A, Lacour J, Lynde C, Marsland A, Maurer M, McBride D, Nakonechna A, Ortiz de Frutoz FJ, Oude Elberink J, Proctor C, Sussman G, Weller K, Grattan C. Comparison of direct healthcare costs associated with chronic spontaneous/idiopathic urticaria in 7 countries - results from the ASSURE-CSU study. Poster presented at the 2016 ISPOR 19th Annual European Congress; November 1, 2016. Vienna, Austria. [abstract] Value Health. 2016 Nov; 19(7):A565.

OBJECTIVES: Limited evidence exists regarding comparative costs associated with inadequately-controlled chronic spontaneous/idiopathic urticaria (CSU/CIU) among countries. This study compares direct healthcare costs associated with CSU across 7 countries.

METHODS: Data came from the ASSURE-CSU study, a non-interventional study quantifying the humanistic and economic burden in CSU patients, symptomatic despite treatment, in Canada, France, Germany, Italy, Spain, the Netherlands, and the United Kingdom (UK). Medical resource utilization data associated with CSU were collected from 12-month retrospective medical records and patient questionnaires. Direct medical resources included therapy costs, healthcare professional (HCP) visits, emergency room visits, hospitalisations, and laboratory tests. Other patient-reported resources included visits to other HCPs, alternative medicine, transportation, and other out-of-pocket expenses in the past 3 months and were annualised. Country-level unit costs were obtained from national sources for 2014 and reported in the respective local currency. To enable comparison across countries, purchasing power parity (PPP) approach was used. Mean (SD) country costs were divided by the corresponding PPP exchange rate published by the Organisation for Economic Co-operation and Development for 2014.

RESULTS: Mean (SD) total annual direct costs for each country were: Italy [PPP$907.1 (2431.1)], Canada [PPP$1025.6 (3673.9)], UK [PPP$1049.2(1131.6)], Germany [PPP$1079.5 (2313.6)], Netherlands [PPP$1092.6 (1731.3)], Spain [PPP$1283.9 (2396.6)], and France [PPP$2984.2 (8969.5)]. Major cost drivers across countries were therapies [PPP$426.4 (836.8) in the UK to PPP$1788.7 (7098.0) in France] and inpatient visits [PPP$36.3 (331.3) in the UK to PPP$1074.4 (2854.8) in France]. Other patient-reported costs ranged from PPP$199.1 (419.6) in Spain to PPP$960.0 (1444.2) in Canada. Overall, total direct costs were notably higher in France, due to therapy cost of intravenous immunoglobulin use and higher inpatient cost.

CONCLUSIONS: CSU is associated with substantial direct healthcare costs across countries. Higher than expected costs associated with CSU suggest the need for effective treatment among the inadequately-controlled CSU patient population.