Eculizumab for paroxysmal nocturnal haemoglobinuria: catastrophic health expenditure in Nepalese patients.
Sugat AdhikariSurendra SapkotaSuraj ShresthaKshitiz KarkiAnjan ShresthaPublished in: Orphanet journal of rare diseases (2023)
Paroxysmal nocturnal hemoglobinuria (PNH) results from a mutation in the phosphatidylinositol glycan class-A gene which causes uncontrolled complement activation with resultant intravascular hemolysis and its sequelae. Eculizumab is a terminal complement inhibitor that blocks this complement activation and has revolutionized the treatment of PNH but comes with an enormous price which can have catastrophic health expenditure in low-middle income countries (LMIC) like Nepal. Here, we discuss the potential way forwards in the treatment of PNH in Nepal and other LMICs.
Keyphrases
- public health
- healthcare
- mental health
- end stage renal disease
- blood pressure
- atrial fibrillation
- obstructive sleep apnea
- chronic kidney disease
- newly diagnosed
- ejection fraction
- physical activity
- coronary artery
- tertiary care
- peritoneal dialysis
- genome wide
- gene expression
- climate change
- copy number
- dna methylation
- social media
- patient reported outcomes
- catheter ablation
- patient reported