Socioeconomics of Administering Rituximab for Nephrotic Syndrome

Nephrotic syndrome is a type of intractable disease caused by a disorder in the kidneys, which produces swelling. Although some patients show rapid improvement and recover completely with conventional treatment, many others experience frequent recurrence (frequently relapsing nephrotic syndrome) while some remain dependent on the same high dose of steroids they were initially prescribed at the start of treatment (steroid-dependent nephrotic syndrome). In the latter cases, side effects of prolonged steroid use are a major issue. Some reports show that administering rituximab is effective in treating patients with steroid resistance. However, drugs like rituximab, directed at specific molecular targets, are generally expensive and therefore need to be evaluated from a health economics perspective before being approved for widespread use. The research team compared the number of relapses and total medical costs in the 24-month period before and the same period after patients took rituximab. We found that relapse decreased from a mean of 4.30 (±2.76) times to 0.27 (±0.52) times, and the total medical costs shrank from USD 2,923 to 1,280 per month (mainly the result of lower inpatient costs). The study also identified a correlation between lower urinary protein levels and a reduction in total medical costs. Rituximab, therefore, proved beneficial in both clinical and cost-effective terms. While rising healthcare costs are becoming a major social problem, we should expect that the development of new drugs with high cost performance will be encouraged from the vantage of socioeconomics.