OBJECTIVES: Immunoglobulin A nephropathy (IgAN) is the most common type of primary glomerulonephritis. The aim of this systematic review was to assess costs and healthcare resource utilization (HCRU) associated with IgAN.

METHODS: Embase, MEDLINE, Pubmed not MEDLINE, and Cochrane databases were searched from 1st Jan 2000 to 1^st April 2021. Additionally, key conference and health technology assessment websites were searched. The quality of the included studies was assessed using the National Institute of Health assessment tool.

RESULTS: A total of six studies from 7,295 identified citations were included. The majority were full-text publications (5) and were from Asia (5). The mean patient age ranged from 35−45 years and their mean estimated glomerular filtration rate ranged from 38−58.5 mL/min/1.73m². Four studies reported data on HCRU. Among 11,569 hospitalised IgAN patients in a Chinese study, 86.5% were admitted to a routine ward and 8% to the emergency department. In another study, 8.8% of patients treated with immunosuppressants were hospitalised for severe infections. Mean length of stay ranged from 10.6 days in Chinese patients to 11.4 days in Japanese patients undergoing tonsillectomy followed by intravenous methylprednisolone. Four studies reported on costs. One Chinese study reported the mean per capita cost for treating IgAN between 2012−2017 as 14,900 CNY. Another study reported the median costs of treating hospitalized IgAN patients as 8,000 CNY. A Japanese cost analysis using a decision-analytic model to compare two diagnostic strategies estimated that screening for IgAN using novel biomarkers versus conventional screening reduced lifetime medical expenses per person by 21,000 USD. The studies were of moderate quality.

CONCLUSIONS: There is scarce evidence on cost and resource use in IgAN patients. Existing evidence shows that current treatments like immunosuppressants and tonsillectomy are burdensome to the healthcare system and this warrants the need for improved, disease-specific therapy in IgAN.