[PAGID] Home IVIG, economics

[Saxon, Andy M.D.]

One note about home IVIG. We started this in the early 1980s [Ashida ER, Saxon A, Home intravenous immunoglobulin therapy by self-administration, J Clin Immunol. 1986 Jul;6(4):306-9] in order to provide for patient convenience, unburden the doctors from unnecessary in/out patient work and to SAVE MONEY for the patients by cutting down on in/out patient costs. This was done by patients and their families using a small "Harvard Pump".  Clearly home Rx is standard of care now.  However, later, once the home infusion companies then got into the business, they have really worked the economics it so that they try to provide a large amount of services including continual nursing etc that many patients don't need, all of which goes as increased economic burden to the patients, some of whom have life time caps on cost. 

Sure some patients need everything done for them including being monitored but many don't and I always warn patients not to have the home care provider do more than the patient wants/needs and often this is just deliver the product, start the IV and leave.

Andy Saxon, UCLA

-----Original Message-----
From: pagid-bounces at list.clinimmsoc.org
[mailto:pagid-bounces at list.clinimmsoc.org]On Behalf Of Conley,
Mary-Ellen
Sent: Tuesday, February 19, 2008 2:58 PM
To: pagid at list.clinimmsoc.org
Subject: Re: [PAGID] Home IVIG


About 80-90% of our patients get their gammaglobulin at home and over the last couple of years about a third of these have moved to SQ.  We see the patients twice a year if they are well, and push telephone contact for any clinical changes.

Mary Ellen




Mary Ellen Conley, MD
Department of Immunology
St. Jude Children's Research Hospital
332 N. Lauderdale
Memphis, TN 38105-2794
FAX  901-495-3977
TEL  901-495-2576


-----Original Message-----
From: pagid-bounces at list.clinimmsoc.org [mailto:pagid-bounces at list.clinimmsoc.org] On Behalf Of Charlotte Cunningham-Rundles
Sent: Tuesday, February 19, 2008 4:16 PM
To: pagid at list.clinimmsoc.org
Subject: Re: [PAGID] Home IVIG

about 70% of ours do. It is just fine, works great.



>Dear Colleagues,

>

>I would like to poll people on home IVIG use.  I am typically opposed

>to it and have found more recently that insurance companies are requesting it.

>During my training, this was never done.  Is there are paradigm shift

>in facilitating home IVIG that I am not aware of?  Thank you for your

>comments, Chris

>

>

>Chris Seroogy, M.D.

>

>Assistant Professor

>

>Dept. of Pediatrics

>

>Mail:  H4/474 CSC, Mailstop 4108

>

>Shipping:  H4/431 CSC, Mailstop 4108

>

>600 Highland Ave.

>

>Madison, WI  53792

>

>phone: 608- 263-2652

>

>fax: 608-265-0164



--


Charlotte Cunningham-Rundles MD PhD
Professor of Medicine, Pediatrics  and Immunobiology Mount Sinai School of Medicine
1425 Madison Ave, New York 10029
phone 212 659 9268
fax  212 987 5593
Email:  charlotte.cunningham-rundles at mssm.edu



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