Iranian Journal of Public Health 2017. 46(3):342-350.

Costs of Hospital Admission on Primary Immunodeficiency Diseases


Background: Primary immunodeficiency diseases (PID) are heterogeneous group of inherited disorders mainly characterized by recurrent infections leading to several times hospital admissions. The economic impact of PID is a challenging issue; therefore, this study was designed to determine the medical costs of hospitalizations in this group of patients as an indicator of the direct cost of these diseases.

Methods: One hundred and ten children with PID hospitalized in the Children’s Medical Center Hospital, Tehran, Iran were included in this study during Jan 2011 and Jan 2012. All direct costs during the admission period were calculated, using the hospital information system.

Results: Medical cost was 7.090$ per patient per admission. Among them, about 1.580$ belong to drug consuming during hospitalization. Anti-infective drugs for systemic use were the most cost-consuming group of drugs, followed by alimentary tract and metabolism and blood and blood forming organs agents. Investigation of anti-infective group internally showed that immune sera and immunoglobulin and antiviral agents for systemic use consisting the most important medication for PID patients during hospital admission.

Conclusion: Although the results of economic evaluations in a region cannot necessarily be applied to other regions, having an overall estimation of hospital admission costs and types of drugs used during admission could be helpful in health policy system.




Cost of diseases; Primary immunodeficiency; Hospitalization; Medical health care; Drugs

Full Text:



Picard C, Al-Herz W, Bousfiha A et al (2015). Primary Immunodeficiency Diseases: an Update on the Classification from the International Union of Immunological Societies Expert Committee for Primary Immunodeficiency 2015. J Clin Immunol, 35(8): 696-726.

Papadopoulou-Alataki E, Hassan A, Davies EG (2012). Prevention of infection in children and adolescents with primary immunodeficiency disorders. Asian Pac J Allergy Immunol, 30: 249-58.

Rezaei N, Aghamohammadi A, Moin M et al (2006). Frequency and clinical manifestations of patients with primary immunodeficiency disorders in Iran: update from the Iranian Primary Immunodeficiency Registry. J Clin Immunol, 26: 519-32.

Aghamohammadi A, Moein M, Farhoudi A et al (2002). Primary immunodeficiency in Iran: first report of the National Registry of PID in Children and Adults. J Clin Immunol, 22: 375-80.

McCusker C, Warrington R (2011). Primary immunodeficiency. Allergy Asthma Clin Immunol, 7 Suppl 1:S11.

Abolhassani H, Sagvand BT, Shokuhfar T, Mirminachi B, Rezaei N, Aghamohammadi A (2013). A review on guidelines for management and treatment of common variable immunodeficiency. Expert Rev Clin Immunol, 9: 561-75.

Aghamohammadi A, Montazeri A, Abolhassani H et al (2011). Health-related quality of life in primary antibody deficiency. Iran J Allergy Asthma Immunol, 10: 47-51.

Errante PR, Franco JL, Espinosa-Rosales FJ, Sorensen R, Condino-Neto A (2012). Advances in primary immunodeficiency diseases in Latin America: epidemiology, research, and perspectives. Ann N Y Acad Sci, 1250: 62-72.

Boyle JM, Buckley RH (2007). Population prevalence of diagnosed primary immunodeficiency diseases in the United States. J Clin Immunol, 27: 497-502.

Geha RS, Notarangelo LD, Casanova JL et al (2007). Primary immunodeficiency diseases: an update from the International Union of Immunological Societies Primary Immunodeficiency Diseases Classification Committee. J Allergy Clin Immunol, 120:776-94.

Notarangelo L, Casanova JL, Conley ME et al. International Union of Immunological Societies Primary Immunodeficiency Diseases Classification C (2006). Primary immunodeficiency diseases: an update from the International Union of Immunological Societies Primary Immunodeficiency Diseases Classification Committee Meeting in Budapest, 2005. J Allergy Clin Immunol, 117: 883-96.

Rezaei N, Pourpak Z, Aghamohammadi A et al (2006). Consanguinity in primary immunodeficiency disorders; the report from Iranian Primary Immunodeficiency Registry. Am J Reprod Immunol, 56: 145-51.

Farhoudi A, Aghamohammadi A, Moin M et al (2005). Distribution of primary immunodeficiency disorders diagnosed in the Children's Medical Center in Iran. J Investig Allergol Clin Immunol, 15: 177-82.

Resnick ES, Bhatt P, Sidi P, Cunningham-Rundles C (2013). Examining the use of ICD-9 diagnosis codes for primary immune deficiency diseases in New York State. J Clin Immunol, 33: 40-8.

Aghamohammadi A, Allahverdi A, Abolhassani H et al (2010). Comparison of pulmonary diseases in common variable immunodeficiency and X-linked agammaglobulinaemia. Respirology, 15: 289-95.

Dedes KJ, Szucs TD, Bodis S et al (2004). Management and costs of treating lung cancer patients in a university hospital. Pharmacoeconomics, 22: 435-44.

Polsky D, Glick H (2009). Costing and cost analysis in randomized controlled trials: caveat emptor. Pharmacoeconomics, 27: 179-88.

Adam T, Evans DB, Murray CJ (2003). Econometric estimation of country-specific hospital costs. Cost Eff Resour Alloc, 1: 3.

Abolhassani H, Aghamohammadi A, Abolhassani F, Eftekhar H, Heidarnia M, Rezaei N (2011). Health policy for common variable immunodeficiency: burden of the disease. J Investig Allergol Clin Immunol, 21: 454-8.

Chan K, Davis J, Pai SY, Bonilla FA, Puck JM, Apkon M (2011). A Markov model to analyze cost-effectiveness of screening for severe combined immunodeficiency (SCID). Mol Genet Metab, 104: 383-9.

McGhee SA, Stiehm ER, McCabe ER (2005). Potential costs and benefits of newborn screening for severe combined immunodeficiency. J Pediatr, 147: 603-8.

Aghamohammadi A, Mohammadinejad P, Abolhassani H et al (2014). Primary immunodeficiency disorders in Iran: update and new insights from the third report of the national registry. J Clin Immunol, 34: 478-90.

WHO (2011). International Statistical Classification of Diseases and Related Health Problems. ed. World Health Organization.

Husty TM, Newell LM (2013). ICD-10: cracking the code. Healthc Financ Manage, 67: 32-5.

Hughes C (2012). The anatomy of an ICD-10 code. Fam Pract Manag, 19: 27-9.

Natsch S, Hekster YA, de Jong R, Heerdink ER, Herings RM, van der Meer JW (1998). Application of the ATC/DDD methodology to monitor antibiotic drug use. Eur J Clin Microbiol Infect Dis, 17: 20-4.

Sadeghi B, Abolhassani H, Naseri A, Rezaei N, Aghamohammadi A (2015). Economic burden of common variable immunodeficiency: annual cost of disease. Expert Rev Clin Immunol, 11: 681-8.

Giuiraud-Chaumeil B (2012). [Intravenous immunoglobulins]. Bull Acad Natl Med, 196: 71-3.

Martin A, Lavoie L, Goetghebeur M, Schellenberg R (2013). Economic benefits of subcutaneous rapid push versus intravenous immunoglobulin infusion therapy in adult patients with primary immune deficiency. Transfus Med, 23: 55-60.

Abolhassani H, Sadaghiani MS, Aghamohammadi A, Ochs HD, Rezaei N (2012). Home-based subcutaneous immunoglobulin versus hospital-based intravenous immunoglobulin in treatment of primary antibody deficiencies: systematic review and meta analysis. J Clin Immunol, 32: 1180-92.

Shapiro RS, Boyle M (2012). Payor issues: barriers to optimal management of patients with primary immunodeficiency. J Clin Immunol, 32: S410-4.

Ballow M (2012). The patient, the physician, and the payor: a multiperspective look at the challenges of treating primary immunodeficiency. J Clin Immunol, 32: S421-2.

Darba J, Restovic G, Kaskens L, de Agustin T (2012). Direct medical costs of liquid intravenous immunoglobulins in children, adolescents, and adults in Spain. J Clin Pharmacol, 52: 566-75.

Connolly M, Simoens S (2011). Kiovig for primary immunodeficiency: reduced infusion and decreased costs per infusion. Int Immunopharmacol, 11: 1358-61.

Beaute J, Levy P, Millet V et al (2010). Economic evaluation of immunoglobulin replacement in patients with primary antibody deficiencies. Clin Exp Immunol, 160: 240-5.

Simoens S (2009). Pharmacoeconomics of immunoglobulins in primary immunodeficie-ncy. Expert Rev Pharmacoecon Outcomes Res, 9: 375-86.

van der Spek J, Groenwold RH, van der Burg M, van Montfrans JM (2015). TREC Based Newborn Screening for Severe Combined Immunodeficiency Disease: A Systematic Review. J Clin Immunol, 35: 416-30.

Harper JC, Wilton L, Traeger-Synodinos J et al (2012). The ESHRE PGD Consortium: 10 years of data collection. Hum Reprod Update, 18:234-47.

Latif AH, Tabassomi F, Abolhassani H, Hammarstrom L (2014). Molecular diagnosis of primary immunodeficiency diseases in a developing country: Iran as an example. Expert Rev Clin Immunol, 10: 385-96.

Dinakar C (2006). Alleviating disease burden in primary immunodeficiency diseases. Ann Allergy Asthma Immunol, 96: 260-2.

Anonymus. Access 2015.

Haddad E, Barnes D, Kafal A (2012). Home therapy with subcutaneous immunoglobulins for patients with primary immunodeficiency diseases. Transfus Apher Sci, 46: 315-21.

Authors (2011). Abstracts of the 2011 CIS (Clinical Immunology Society) Annual Meeting. Chicago, Illinois, USA. May 19-22, 2011. J Clin Immunol, 31: S1-71.


  • There are currently no refbacks.

Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.