Infliximab cost-effective for refractory Kawasaki disease

For patients with Kawasaki disease (KD) refractory to initial treatment such as steroids, immunosuppressors and intravenous immunoglobulins, infliximab treatment may be a cost-effective option, reports a recent study.

Researchers conducted a multicentre, retrospective cohort study using data from Japan’s public medical insurance database. The analysis included 1,267 patients who had undergone and had failed at least one prior line of KD treatment from April 2012 and March 2019. Cost-effectiveness, the primary outcome, was calculated by dividing the number of admissions per annum by the yearly medical expenses.

Twenty-five KD patients were given infliximab while the 206 received other non-infliximab interventions after their KD was designated as refractory.

Over a median follow-up of 366 days, there were 1.21 admissions per annum in the infliximab-treated patients, with a total medical cost of 10,939 USD per annum. In comparison, 1.65 admissions per annum were reported in the non-infliximab group over a median follow-up of 467 days. The total medical cost per annum in these patients was 10,656 USD.

The resulting respective cost-effectiveness measures were 1.04 and 1.42 events per 10,000 USD, representing a statistically significant difference (p=0.008). Infliximab remained significantly more cost-effective than other treatments after propensity score matching.

“Further studies with the larger number of participants are required to confirm the differences in health outcomes between patients treated with and without infliximab and between early and later initiation of infliximab,” the researchers said.