Economic analysis of the use of Anti-DFS70 antibody test in patients with undifferentiated systemic autoimmune disease symptoms

Luca Moroni, Gabriela Restovic, Ricard Cervera, Gerard Espinosa, Odette Viñas, Milagros García, Laura Sampietro-Colom

Research output: Contribution to journalArticlepeer-review

Abstract

Objective. In patients with antinuclear antibodies (ANA) and undifferentiated features of systemic autoimmune disease, the coexistence of monospecific anti-dense fine speckled 70 (anti-DFS70) antibodies is associated with a lower risk of progression to overt disease. Therefore, they might help in correctly classifying ANA- positive patients and avoiding unnecessary followup diagnostic procedures. The aim of this study was to analyze the economic effect of the introduction of the anti-DFS70 antibody test in a hospital setting. Methods. A case-control study was performed to detect monospecific anti-DFS70 antibodies in ANA-positive subjects with undifferentiated features (cases, n = 124) and with a defined systemic autoimmune disease (controls, n = 290). Based on current clinical practice, a decision tree was developed to represent the disease course of patients with undifferentiated features in the subsequent 3 years. A budget impact analysis (BIA) was performed to estimate the effect of implementing the screening for anti-DFS70 antibodies in the case group on the total costs. A sensitivity analysis was conducted to calculate the effect of the uncertainty of the input variables on the results. Results. Among the 124 patients in the case group, 5 (4.0%) tested positive for anti-DFS70 antibodies versus 4/290 (1.4%) in the control group (p = not significant). The mean cost per patient under the current clinical practice decreased from -3274 to -3192 in our scenario. The BIA reports cost savings of -10,128. Conclusion. The introduction of anti-DFS70 antibody test would avoid unnecessary followup diagnostic procedures and minimize the use of health resources generated by suspicion of a potential systemic autoimmune disease.

Original languageEnglish
Pages (from-to)1275-1284
Number of pages10
JournalJournal of Rheumatology
Volume47
Issue number8
DOIs
Publication statusPublished - Aug 1 2020

Keywords

  • ANTI-DFS 70 antibody
  • Antinuclear antibodies
  • Economic effect
  • Systemic autoimmune disease
  • Undifferentiated connective tissue disease

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

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