The Economic Value of Self-Administered Subcutaneous Immunoglobulin G (SCIg) in Canada: A Scoping Review
Author(s)
Antoinette Cheung, MPH1, Megan Manuel, MSc1, Stephen Mac, PhD2, Romina Fakhraei, PhD1, Aidan Giangregorio, MSc2, Stephen D. Betschel, HBSc, MD, FRCPC, FAAAAI3.
1Broadstreet HEOR, Vancouver, BC, Canada, 2Takeda Canada Inc., Toronto, ON, Canada, 3Unity Health, Toronto, ON, Canada.
1Broadstreet HEOR, Vancouver, BC, Canada, 2Takeda Canada Inc., Toronto, ON, Canada, 3Unity Health, Toronto, ON, Canada.
OBJECTIVES: SCIg is a treatment available in Canada for patients requiring antibody replacement. While standard-of-care involves in-hospital intravenous Ig (IVIg) treatment, SCIg allows for home-based administration and fewer clinic visits, representing a common treatment choice. This study aimed to summarize the economic value of SCIg versus IVIg treatment in Canada.
METHODS: A scoping review was conducted using Medline and Embase, supplemented by grey literature searches. Eligibility criteria were observational studies and economic evaluations reporting cost and healthcare resource use (HCRU) outcomes of SCIg or IVIg treatment in Canada (any condition). Types and estimates of costs (Canadian dollars [CAD]), cost-effectiveness, and HCRU were extracted and summarized.
RESULTS: From 824 database abstracts and 10 grey literature citations, 21 eligible articles were included; articles without Canadian economic data for IVIg or SCIg were excluded. Reduced costs and HCRU were reported for SCIg versus IVIg (n=7 studies) where reductions in total cost ranged from $1,795-$5,386/patient/year. Staffing time and lost productivity were also lower; SCIg required 45-57 fewer nursing hours/patient/year, and 51-82 fewer parental hours/patient/year. Lower costs with SCIg were driven by reduced infusion materials, staff time, transportation to clinics, and lost productivity. Three economic models described substantial cost savings after switching patients from IVIg to SCIg, with one model estimating cost savings up to $35 million (2011 CAD) over a 3-year period. In a cost-utility analysis, SCIg was less costly while providing greater quality-adjusted life-years than hospital-based IVIg, even when hospital/staff costs for IVIg were lowered by 50%.
CONCLUSIONS: This review highlights the value of SCIg in reducing burden to the Canadian healthcare system, while improving patients’ independence. Limitations include the sparsity of recent Canadian economic evidence, and potential for underestimating SCIg use; as such, cost savings may be even greater. Future studies are needed to evaluate the long-term economic impact of SCIg treatment in Canada.
METHODS: A scoping review was conducted using Medline and Embase, supplemented by grey literature searches. Eligibility criteria were observational studies and economic evaluations reporting cost and healthcare resource use (HCRU) outcomes of SCIg or IVIg treatment in Canada (any condition). Types and estimates of costs (Canadian dollars [CAD]), cost-effectiveness, and HCRU were extracted and summarized.
RESULTS: From 824 database abstracts and 10 grey literature citations, 21 eligible articles were included; articles without Canadian economic data for IVIg or SCIg were excluded. Reduced costs and HCRU were reported for SCIg versus IVIg (n=7 studies) where reductions in total cost ranged from $1,795-$5,386/patient/year. Staffing time and lost productivity were also lower; SCIg required 45-57 fewer nursing hours/patient/year, and 51-82 fewer parental hours/patient/year. Lower costs with SCIg were driven by reduced infusion materials, staff time, transportation to clinics, and lost productivity. Three economic models described substantial cost savings after switching patients from IVIg to SCIg, with one model estimating cost savings up to $35 million (2011 CAD) over a 3-year period. In a cost-utility analysis, SCIg was less costly while providing greater quality-adjusted life-years than hospital-based IVIg, even when hospital/staff costs for IVIg were lowered by 50%.
CONCLUSIONS: This review highlights the value of SCIg in reducing burden to the Canadian healthcare system, while improving patients’ independence. Limitations include the sparsity of recent Canadian economic evidence, and potential for underestimating SCIg use; as such, cost savings may be even greater. Future studies are needed to evaluate the long-term economic impact of SCIg treatment in Canada.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE707
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Biologics & Biosimilars, Oncology, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)