SCIG Therapy Is Cost-Saving Versus IVIG in Canadian Study of Primary Immunodeficiency Patients

This first-ever prospective economic analysis by Canadian investigators found that, from both hospital- and health systembased perspectives, home-based subcutaneous immune globulin (SCIG) therapy was associated with significantly lower average total nondrug costs than hospital-based intravenous immune globulin (IVIG) therapy for patients with primary immunodeficiency disorders.

The analysis included 30 adult patients in the IVIG group and 27 patients in the SCIG group. The average age and baseline weight were not significantly different between the two groups. Patients on IVIG therapy typically came to the hospital every three to four weeks where a nurse inserted an intravenous line for infusions that generally required about two to three hours. Initiation of SCIG treatment required training by a qualified nurse, generally in a single one-on-one visit. Once patients had been trained, they infused the product on their own at home, generally in small volumes ranging from one to seven times per week. For patients transitioning from IVIG to SCIG at the beginning of the study, treatment was initiated at a dose equivalent to the previous IVIG dose, given once a week.

Over the 12-month study period, all nondrug hospital costs (including hospital nurses and technicians) and physician visit costs were respectively $1,836 and $84 for the SCIG group, and $4,187 and $744 for the IVIG group. “SCIG has significantly decreased costs for the Canadian health care system compared with IVIG,” the investigators concluded. “It should be considered in patients who are currently on IVIG and in those who are to start immunoglobulin replacement therapy.”