Presentation (CTI)

OBJECTIVES: To compare human normal immunoglobulin (IV and SC) presentations within each administration route using a rule-based multicriteria decision model, prioritizing infusion-chair throughput (bed turnover) and estimating the potential for increased reimbursable session volume in an infusion center.
METHODS: A rule-based MCDA was built and applied separately for intravenous immunoglobulin (IVIG) and subcutaneous immunoglobulin (SCIG). The primary outcome was annual chair-time use and capacity released; secondary outcomes were annual treatment cost (drug plus administration materials, 2025 BRL) and adverse-event (AE) rates. For IVIG, a fixed reimbursement package per infusion was assumed to be identical across IV presentations. Real-world IVIG utilization over 6 months was used to simulate product-substitution scenarios. Center capacity was 8 chairs, operating 6 days/week (07:00-20:00) with 75% average occupancy. Mean observed visit duration was 420 minutes.
RESULTS: In the 6-month baseline, IVIG use consumed 413.6 chair-hours. Simulated substitution to the shortest-chair-time IVIG reduced chair-hours to 332.7 (-80.9 hours/6 months), equivalent to -161.8 hours/year and approximately 23 additional IV sessions/year (161.8/7 hours). A moderate-time IVIG scenario reduced chair-hours to 361.8 (-51.8 hours/6 months), equivalent to -103.6 hours/year and approximately 15 additional sessions/year. Within SCIG, the lowest chair-time option required 90 minutes per visit and 39 hours/year versus 48 hours/year for the comparator (240 minutes/visit), releasing approximately 9 chair-hours/year. In IVIG, the lowest annual cost in the base-case was BRL 126,420/patient-year, while faster or moderate-time options were BRL 139,082 and BRL 143,790/patient-year. AE rates favored one IVIG 10% option (0.42%) and one SCIG option (0.02%).
CONCLUSIONS: Optimizing immunoglobulin presentation selection can materially increase infusion-center throughput. Under fixed per-infusion reimbursement, released chair-time translates into potential incremental reimbursable sessions, supporting revenue growth when demand expands, while highlighting trade-offs between throughput, cost, and safety<!--ScriptorEndFragment-->