Economic benefit of subcutaneous rapid push versus intravenous immunoglobulin infusion therapy in adult patients with primary immune deficiency
Bibliographic record
Abstract
Primary immune deficiencies (PID) are genetic disorders resulting in recurrent infections. Immunoglobulin replacement therapy in PID patients can be achieved intravenously (IVIG) or subcutaneously (SCIG) with similar efficacy and safety profiles but with different resource use and associated costs. SCIG and IVIG options for immunoglobulin replacement therapy in adult PID patients were compared in a cost-minimization model over three years of treatment. The model focused on direct medical costs for infusion supplies and personnel. A three-year budget impact model assessed the economic impact on the healthcare system of switching from IVIG to SCIG for PID patients of the BC Central Transfusion Registry. Sensitivity analyses were performed for both models to measure the effect of different modalities of IVIG treatment and of the proportion of patients switching from IVIG to SCIG. The cost-minimization model estimated SCIG treatment cost per patient over three years at $1978 compared to $7714 for IVIG, resulting in savings to the healthcare system of $5736, principally due to reduced hospital personnel costs. This figure varied from $5035 to $8739 for different modalities of IVIG therapy. Assuming that 50% of patients who received IVIG switched to SCIG, the budget impact model estimated cost savings for the first three years at $1,307,894 or 37% of the personnel and supply budget. This study demonstrated that rapid push home-based SCIG was less costly than hospital-based IVIG for immunoglobulin replacement therapy. This approach provides not only a beneficial option from the patient perspective but also results in significant savings to the healthcare system for immunoglobulin replacement therapy in adult PID patients in a Canadian context.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".