Intravenous Immunoglobulin: A Quick Look at Treatment and Insurance Coverage

A slightly complicated treatment option for individuals who do not produce enough antibodies (our body’s defense against infections) is the administration of intravenous immunoglobulin (IVIg). Plasma donated by thousands of individuals is used to create a highly concentrated solution with diverse antibodies.

What is IVIg USED FOR?

• Antibody deficiencies, meaning your body is not able to make sufficient antibodies which play a vital role in protecting against infections
• Autoimmune conditions in which the immune system attacks your own cells such as platelets, red blood cells, or nerves
  • IVIg can prevent the immune system from attacking its own cells

How is IVIG administered?

IVIg is administered intravenously in a doctor’s office or infusion center, over a period of several hours. Frequency of administration depends on the disease and the course of treatment:

• Antibody replacement: smaller doses administered regularly
• Autoimmune treatment: few larger doses

Examples of conditions IVIG can treat

• Kawasaki’s disease in children
• Inflammatory muscle diseases such as dermatomyositis, polymyositis, and juvenile dermatomyositis
• Systemic lupus erythematosus

Risks and Side Effects

The risk of blood-borne infection from IVIg products is low because it is a highly purified product. Side effects of treatment may include:

• Chills or fever
• Headache
• Stomach pain
• Feeling sick or vomiting
• Joint pain
• Low back pain
• Tiredness

Some patients may experience severe allergic reactions to IVIg during the infusion process. It is important to inform the person administering the infusion if you have:

• Chest tightness
• Breathing problems
• Rash
• Swelling of face or tongue
• Drop in blood pressure

Certain preventive measures can help avoid some of the side effects associated with IVIg administration:

• Conduct a blood test prior to initiating IVIg treatment
• Ensuring you remain well hydrated during administration, and taking extra fluids
• Slow administration of infusion
• Split a large dose into several smaller doses, which can then be administered over several days
• Administering a pain-relieving medication before infusion

Contraindication: Vaccination in the weeks or months after IVIg administration. It is important to speak about the timing of administering your vaccines if you are receiving IVIg.

Additional Tips

Keep a record of the product number and IVIg infusion date, in case of a side effect. Also, if a specific brand works for you, it is safer to continue using it and avoid switching to a different brand.

Is IVIg Treatment Expensive? What Will My Insurance Cover?

IVIg is reported to cost $9,270 per infusion (average price). Patients typically receive 4-5 infusions per month. So, the monthly cost would be North of $41,000.

• Medicare will provide coverage for IVIg for:
  • Primary immunodeficiency
  • Immune-mediated Thrombocytopenia (ITP)
  • Kawasaki disease
  • Human Immunodeficiency Virus (HIV) (for pediatric use only)
  • Bone marrow transplantation
  • Chronic B-cell lymphocytic leukemia

Other conditions such as neuropathy, multiple sclerosis, systemic lupus erythematosus, etc., but restrictions apply. You can find specific coverage information on this page.

• Private payer policies may vary. It’s best to call your payer and confirm their coverage for IVIg treatment.

The Immune Deficiency Foundation has created a guideline that advices payers on adopting medically appropriate policies around immunoglobulin therapy for primary immunodeficiency.

Patient Assistance Programs

Here is some information on financial assistance programs that you can apply for: Financial assistance for IVIg treatment.

Resources Used:

Versus Arthritis

American College of Rheumatology

UpToDate

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