Article Text
Abstract
Background Non-specific intravenous immunoglobulin (IgIVC) preparations are one of the products of human plasma fractionation. In clinical practice these drugs are expensive as they are used as replacement therapy in patients with primary and secondary immunodeficiencies, as well as immunomodulatory therapy in many autoimmune diseases and systemic inflammatory diseases.
Purpose The purpose of this study was to compare IgIVC consumption and economic costs before and after performing IgIVC fractionation of doses in our hospital.
Material and methods Descriptive observational study in a tertiary teaching care hospital with 413 beds. All patients, both inpatients and outpatients, who received IgIVC from July 2011 to July 2015 were reviewed. Data collected from each patient included age, gender, clinical diagnosis, dosage regimen, unit consumed and cost in Euros.
Data were recorded from July 2011 to June 2013 and then from July 2013 to July 2015. During the first stage, the purchased IgIVC doses were 0.5 2.5 5 and 10 g. During the second stage, only 0.5 and 10 g doses were purchased, and the 2.5 and 5 g doses were obtained by splitting the 10 g dose. In this way, one 10 g dose yielded two doses of 5 g and four doses of 2.5 g.
Results Between July 2011 and July 2015, 231 patients received doses of IgIVC. Of these,103 (44.58%) were female patients. The most prevailing drug indications were essential thrombocythemia, non-toxic inflammatory neuropathies and myasthenia gravis. The total economic cost was 1 913 730.26€.
From July 2011 to June 2013, 96 (41.55%) patients received IgIVC which involved a total economic cost in euros of 871 504.75€ (45.54%). On the other hand, from July 2013 to July 2015, 129 (55.84%) patients received IgIVC, costing 1 024 225.510€ (54.56%).
If no fractionated doses of 5 and 2.5 g had been used, the cost from July 2013 to July 2015 would have been 1 082 159.58€, therefore performing fractionated doses of IgIVC provided economic savings of 39 934.07€ (3.70%) over 2 years.
Conclusion IgIVC administration has increased over the past 4 years. The economic cost has been greatly reduced by fractionation of doses performed at our hospital.
No conflict of interest.