The European Journal of Health Economics

, Volume 6, Issue 1, pp 24–29

Pharmacoeconomic evaluation of immunoglobulin treatment in patients with antibody deficiencies from the perspective of the German statutory health insurance

  • Barbara Högy
  • Heinz-Otto Keinecke
  • Michael Borte
Original Papers


Primary antibody deficiencies are the most common forms of primary immunodeficiencies. Substitution therapy with polyvalent immunoglobulins has been established as the standard therapy for antibody deficiencies for several decades. Until now mainly intravenous immunoglobulins (IVIG) have been used in Germany, and the majority of patients receive treatment in hospital outpatient clinics. In recent years subcutaneous administration of immunoglobulins (SCIG) has been developed which is administered as home self-infusion. Studies indicate no significant differences in immunoglobulin substitution therapy between SCIG and IVIG concerning outcome. We carried out a cost-minimization analysis to compare the two treatment alternatives in Germany. Under base case assumptions the treatment with SCIG is cost saving from the perspective of the German statutory health insurance. The main cost drivers are IVIG and SCIG; the incremental cost of SCIG compared to IVIG is most sensitive to changes in the immunoglobulin price and changes in the body weight of the patient.


Primary immunodeficiency Immunoglobulin therapy Subcutaneous therapy Cost-minimization analysis Germany 


  1. 1.
    Andersen V, Franke K, Erkel J et al. (2001) Subkutane IgG-Infusion bei Patienten mit primärem Immundefekt-eine retrospektive Fallsammlung. Mitt Bayer Ges Immun, Tropenmed Impfwesen 18:14Google Scholar
  2. 2.
    Borte M, Oertelt C, Keinecke HO et al. (2003) Die Behandlung des primären Antikörpermangels in Deutschland-Ergebnisse einer Umfrage. Monatsschr Kinderheilkd 151 [Suppl 1]:KHP 02.110Google Scholar
  3. 3.
    Chapel HM, Spickett GP, Ericson D et al. (2000) The comparison of the efficacy and safety of intravenous versus subcutaneous immunoglobulin replacement therapy. J Clin Immunol 20:94Google Scholar
  4. 4.
    Gardulf A, Hammarström L (1996) Subcutaneous administration of immunoglobulins—what are the advantages? Clin Immunother 6:108Google Scholar
  5. 5.
    Gardulf A, Andersen V, Björkander J et al. (1995) Subcutaneous immunoglobulin replacement in patients with primary antibody deficiencies: safety and costs. Lancet 345:365Google Scholar
  6. 6.
    Hansen S, Gustafson R, Smith CIE et al. (2002) Express subcutaneous IgG infusions: decreased time of delivery with maintained safety. Clin Immunol 104:237Google Scholar
  7. 7.
    Schöffski O, Uber A (2000) Grundformen gesundheitsökonomischer Evaluationen. In: Schöffski O, Graf v.d. Schulenburg M (eds) Gesundheitsökonomische Evaluationen, 2nd edn. Spinger, Berlin Heidelberg New YorkGoogle Scholar
  8. 8.
    Schwartz SA (2000) Intravenous immunoglobulin treatment of immunodeficiency disorders. Pediatr Clin North Am 47:1355Google Scholar
  9. 9.
    Sorensen RU, Moore C (2000) Antibody deficiency syndromes. Pediatr Clin North Am 47:1225Google Scholar

Copyright information

© Springer Medizin Verlag 2004

Authors and Affiliations

  • Barbara Högy
    • 1
  • Heinz-Otto Keinecke
    • 2
  • Michael Borte
    • 3
    • 4
  1. 1.Aventis Behring GmbHMarburgGermany
  2. 2.Covidence GmbHMarburgGermany
  3. 3.Children’s HospitalMunicipal Hospital St. GeorgLeipzigGermany
  4. 4.Klinik f. Kinder- u. Jugendmedizin am Städtischen Klinikum St. Georg LeipzigAkademisches Lehrkrankenhaus der Universität LeipzigLeipzigGermany

Personalised recommendations