A Comparison Of Costs Between Outpatient Hospital, Clinic and Home Settings For Intravenous Immunoglobulin (IVIG) Infusions

Home-based infusion of IVIG therapy may be beneficial in terms of reduced costs compared to the outpatient hospital (OH) or clinic setting. This analysis assessed cost differences between infusions conducted at home versus OH or clinic using data from a large, commercial medical claims database. Patients who had at least 3 months of continuous IVIG claims were identified using J codes from the Truven Marketscan Database, years 2002 -2012. Those who switched their infusion site of care from the OH or the clinic to the home setting and had 3 or more IVIG claims in each site of care were identified. Costs of care were compared between the home and OH or clinic setting. Monthly costs were calculated for each site, and the ratio between monthly cost at home and monthly cost in the OH or clinic was calculated for each patient. Signed rank test was used to determine statistical significance between sites. There were 83 and 79 patients who switched their IVIG infusion sites between clinic and home or OH and home, respectively. Switching from OH to home infusions resulted in significantly lower median costs ($6,916 v $4,188). The median home-to-OH cost ratio was 0.61 (p<0.0001), indicating the costs of care for the home-based infusions were significantly less than the OH setting. The differences in costs between clinic and home were not significant. In this study, switching patients on IVIG treatment from the OH to the home setting resulted in significant cost savings.