To use consensus-building methodologies to prioritize disease states for intravenous immunoglobulin (IVIG) utilization while considering disease severity and alternative therapeutic options. METHODS: A 7-member expert panel independently ranked 50 disease states across 2 domains: (1) Disease severity (DS) (1=immediately life-threatening, 2=life-threatening, 3=life-modifying, 4=other) and (2) the perceived efficacy of therapeutic alternatives (TA) (1=none, 2=low, 3=medium, 4=high). An interquartile deviation of ≤0.5 was used to determine consensus for disease states within each domain. Disease states reaching consensus across both domains were ranked according to a 4x4 algorithmic scale to establish priority. RESULTS: The panel reached consensus on the severity of all diseases states; however, 11 of the 50 disease states did not reach consensus on the availability of alternative therapeutic options. No disease state was designated as being immediately life-threatening without an available alternative therapeutic option (DS1TA1), while 3 disease states (X-linked agammaglobulinemia, common variable immunodeficiency, primary immunodeficiency with absent B-cells) were designated as life-threatening with no therapeutic alternatives (DS2TA1). The priority distribution of disorders based on the algorithm is as follows: DS1TA1=0, DS1TA2=1, DS1TA3=1, DS1TA4=1 DS2TA1=3, DS2TA2=4, DS2TA3=3, DS2TA4=1 DS3TA1=0, DS3TA2=7, DS3TA3=14, DS3TA4=0 DS4TA1=0, DS4TA2=0, DS4TA3=3, DS4TA4=1 CONCLUSIONS: The application of interquartile deviation in establishing consensus across two 4-point Likert scales resulted in prioritizing 80% of disease states where IVIG can be used. Additional consensus-building rounds will be needed to prioritize the remaining disease states.