Cost-effectiveness of enzyme replacement therapy for Fabry disease

Table 2 Dutch unit costs (€) for resources used

Resource	Unit costs in 2009 (€)#	Source
Inpatient hospital day
AMC	596-1,036	AMC hospital ledger##
Elsewhere*	457	Dutch costing manual**
Inpatient hospital ICU day	2,183	Dutch costing manual
In-hospital day-care treatment
AMC	274 - 845	AMC hospital ledger
Elsewhere	251	Dutch costing manual
Agalsidase α/β*** per patient per year	200,000	Report manufacturer 2010; z-index 2007
Kidney dialysis per year	60,000	[19, 20]
Kidney transplantation
first year	60,000	[19, 20]
follow-up per year	not included
Other diagnostic and therapeutic procedures	Various	AMC hospital ledger
Outpatient hospital visit
AMC	90 - 460	AMC hospital ledger
Elsewhere*	72	Dutch costing manual
Out-of-hospital visit
General practitioner	28	Dutch costing manual
Physiotherapist	36	Dutch costing manual
Psychiatrist/psychologist†	91.5	Dutch costing manual
Occupational physician/other††	26	AMC hospital ledger
Social worker	65	Dutch costing manual
Alternative healer	60	Expert opinion†††
Productivity loss per hour^	30	Dutch costing manual

# In case of different base years the general price index figures from the Dutch costing manual 2010 have been used to derive 2009 estimates. ## Unit costs from the AMC hospital ledger for Fabry patients include the costs of top referent health care. * Weighted unit cost based on 88% general and 12% academic inpatient days.** Unit costs from the most recent Dutch costing manual [21]. *** Weighted mean costs of therapy per patient of 70 kg per year. The costs per patient per year of full treatment amount to €198,640 for agalsidase-α and €201,346 (price-indexed for 2009) for agalsidase-β. † Weighted unit cost based on the assumption of 50%-50% distribution of visits over psychiatrists (€103) and psychologists (€80) respectively. †† Out-of-hospital visit to other care givers are assigned the lowest unit costs among the caregivers, i.e. the occupational physician. ††† The Nederlandse Mededingings Autoriteit prohibits the use of an advised tariff. Unit costs per consultation may vary considerably, depending on the type of alternative healer. As a proxy, the reported unit cost of € 60 per visit is based on an indexed derivation of the advised 2000 tariff for an acupuncturist. ^ Mean unit costs per hour across gender and age groups.

ISSN: 1750-1172