The administration of subcutaneous Immunoglobulin (SCIg) is a safe and convenient alternative to intravenous immunoglobulin (IVIg) therapy. Administration of SCIg can occur via an infusion pump or rapid push technique. Based on patients at a Canadian site where patients are presented with both decisions and the direct cost differences to patients explained. Ourexperience has shown that the pump has an overwhelming higher preference amongst patients.
This is a chart review of immune deficient patients at a private clinic who initiated treatment with SCIg therapy between January 2014 and April 2015. Patients were given the option to choose which method they desired after being shown both techniques and determining the difference in cost for each method. Their dosage amounts were confirmed, and they were each shown the amount of time it would take for them to infuse via the pump versus rapid push.
Charts for the first 25 patients (12 male, 13 female, ranging in age from 40 to 80) were reviewed. Fifteen patients chose the pump and 5 patients chose the push method. Out of the 15 patients, only 2 patients were not covered by insurance. Out of the 5 patients who chose the push method, 3 had to pay out of pocket. The 5 remaining patients were either lost to follow up or switched back to IVIg. Dosage amounts varied in both methods of delivery.
The results clearly show that immune deficient patients did have a higher preference for administering SCIg through the pump rather than pushing by hand, and it wasn't in relation to the time spent, but the overall cost and freedom it granted the patient. This may be a result of more immune deficient patients being diagnosed within the aging population particularly for secondary immune deficiencies.