Economic burden and quality of life of IgG4-related disease in China: A comparative analysis of three treatment regimens.
7 affiliations
- 1Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Rheumatic and Autoimmune Diseases (NCRC-RAD), State Key Laboratory of Complex Severe and Rare Diseases, The Ministry of Education Key Laboratory, Beijing, China.
- 2Department of Rheumatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
- 3Department of Basic Medical Science, School of Medicine, Tsinghua University, Beijing, China.
- 4Department of Rheumatology, Qingdao Municipal Hospital Group, Qingdao, Shandong Province, China.
- 5Department of Planning and Development, Peking Union Medical College Hospital, Beijing, China.
- 6National Human Genetic Resource Center, Beijing, China.
- 7National Research Institute for Family Planning, Beijing, China.
Abstract
Background and objectives
IgG4-related disease (IgG4-RD) is a chronic fibroinflammatory disorder requiring prolonged treatment, placing substantial financial burden on patients. This study compares the direct medical costs of three treatment regimens-glucocorticoid (GC), GC combined with Mycophenolate mofetil (MMF), and rituximab (RTX) -and evaluates the patients' health-related quality of life (HR-QoL) using the EuroQol 5-Dimension 5-Level scale (EQ-5D-5 L) to assess cost-effectiveness.Methods
Our retrospective cohort study consecutively distributed EQ-5D-5 L questionnaires to treatment-naïve IgG4-RD outpatients. Patients formed three cohorts: 30 with GC, 30 with GC+MMF, and 20 with RTX. Patients on other regimens were excluded. HR-QoL was assessed using EQ-5D-5 L questionnaires and visual analog scales. Quality-adjusted life years (QALYs) were calculated, and incremental cost-effectiveness ratios were computed. Probabilistic sensitivity analysis with Monte Carlo simulations evaluated cost-effectiveness across willingness-to-pay thresholds.Results
First-year treatment costs were $1284.53 for GC, $2090.96 for GC+MMF, and $6175.97 for RTX. RTX group demonstrated the lowest relapse rate. No significant differences were observed in HR-QoL scores among groups, though visual analog scale (VAS) scores favored GC over GC+MMF. Median incremental cost-effectiveness ratios of probabilistic sensitivity analysis were $13,310/QALY for RTX versus GC and $17,412/QALY for RTX versus GC+MMF. GC demonstrated highest cost-effectiveness probability at willingness-to-pay thresholds below $15,000/QALY. Inverse probability of treatment weighting analysis confirmed these findings' robustness after controlling for selection bias.Conclusions
While RTX offers superior efficacy with lowest relapse rates, its high price leads to limited usage in China. GC-based regimens provide reasonable outcomes at lower costs, making GC or GC+MMF more economical choices.
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BibTeX
@article{wang2026economic,
title = {{Economic burden and quality of life of IgG4-related disease in China: A comparative analysis of three treatment regimens.}},
author = {Yifei Wang and Jialing Jiang and Yuxue Nie and Jingna Li and Jialei Zhang and Qinhuan Luo and Xinli Yang and Nianyi Zhang and Shuo Liu and Jueming Lei and Jiaxin Zhou and Yunyun Fei and Linyi Peng and Wen Zhang},
journal = {Rheumatology and immunology research},
year = {2026},
month = oct,
doi = {10.1515/rir-2026-0031},
url = {https://europepmc.org/article/MED/42924285},
note = {CC BY},
}
RIS
TY - JOUR
TI - Economic burden and quality of life of IgG4-related disease in China: A comparative analysis of three treatment regimens.
AU - Yifei Wang
AU - Jialing Jiang
AU - Yuxue Nie
AU - Jingna Li
AU - Jialei Zhang
AU - Qinhuan Luo
AU - Xinli Yang
AU - Nianyi Zhang
AU - Shuo Liu
AU - Jueming Lei
AU - Jiaxin Zhou
AU - Yunyun Fei
AU - Linyi Peng
AU - Wen Zhang
PY - 2026
DA - 2026/10/22
JO - Rheumatology and immunology research
DO - 10.1515/rir-2026-0031
UR - https://europepmc.org/article/MED/42924285
AB - Background and objectives IgG4-related disease (IgG4-RD) is a chronic fibroinflammatory disorder requiring prolonged treatment, placing substantial financial burden on patients. This study compares the direct medical costs of three treatment regimens-glucocorticoid (GC), GC combined with Mycophenolate mofetil (MMF), and rituximab (RTX) -and evaluates the patients' health-related quality of life (HR-QoL) using the EuroQol 5-Dimension 5-Level scale (EQ-5D-5 L) to assess cost-effectiveness.Methods Our retrospective cohort study consecutively distributed EQ-5D-5 L questionnaires to treatment-naïve IgG4-RD outpatients. Patients formed three cohorts: 30 with GC, 30 with GC+MMF, and 20 with RTX. Patients on other regimens were excluded. HR-QoL was assessed using EQ-5D-5 L questionnaires and visual analog scales. Quality-adjusted life years (QALYs) were calculated, and incremental cost-effectiveness ratios were computed. Probabilistic sensitivity analysis with Monte Carlo simulations evaluated cost-effectiveness across willingness-to-pay thresholds.Results First-year treatment costs were $1284.53 for GC, $2090.96 for GC+MMF, and $6175.97 for RTX. RTX group demonstrated the lowest relapse rate. No significant differences were observed in HR-QoL scores among groups, though visual analog scale (VAS) scores favored GC over GC+MMF. Median incremental cost-effectiveness ratios of probabilistic sensitivity analysis were $13,310/QALY for RTX versus GC and $17,412/QALY for RTX versus GC+MMF. GC demonstrated highest cost-effectiveness probability at willingness-to-pay thresholds below $15,000/QALY. Inverse probability of treatment weighting analysis confirmed these findings' robustness after controlling for selection bias.Conclusions While RTX offers superior efficacy with lowest relapse rates, its high price leads to limited usage in China. GC-based regimens provide reasonable outcomes at lower costs, making GC or GC+MMF more economical choices.
SN - 2719-4523
ER -