Objectives To evaluate the utilisation of intravenous immunoglobulin (IVIG) at Tawam Hospital, a tertiary care teaching hospital, over a 1-year period.
Methods Patients who received IVIG from March 2010 to April 2011 at Tawam Hospital were identified retrospectively using the hospital computer system. Their charts were subsequently reviewed and data were collected on patients' demographics, indication, dose regimen, adverse drug reactions and physician specialty. Indications were placed into three main categories: US Food and Drug Administration (FDA) labelled; off-label indications with evidence favouring IVIG efficacy; and off-label indications with lack of evidence for efficacy.
Results A total of 134 patients (74 paediatric and 60 adult) were identified. In 39%of paediatric versus 46% of adult patients, IVIG was dispensed for appropriate indications (US FDA labelled and off-label with support for use). However, 61%of paediatric patients and 54% of adult patients received IVIG for inappropriate indications (off-label use without support). The estimated annual cost of IVIG is US$1.25 million, of which US$0.7 million was considered as inappropriate use.
Conclusions A significant amount of IVIG was prescribed for inappropriate indications, resulting in a large financial burden on the institution.