OBJECTIVES: To describe the savings generated by the rational use of immunoglobulin replacement therapy (IgRT) in a comprehensive care program for patients with immunodeficiencies.

METHODS: A descriptive cross-sectional study in patients who attended Helpharma IPS between March 2023 - May 2024. Patients were evaluated by a team of physicians, immunologists, and pharmacists and established optimization strategies (change to a more economical therapy, decrease in dosage, increase in treatment frequency) or suspension of therapy due to adequate disease control, increase in immunoglobulin levels (IgG > 1000 or in normal ranges for age) and reduction of severe infections. Univariate analysis was performed using the statistical package R Core Team Version 4.2 (2022).

RESULTS: We identified 794 patients with IgRT of which 24 patients (2.9%) had optimization of therapy. Median age was 17 years (RIC 30), 56.5% were female, with diagnoses of common variable immunodeficiency 26.1%, immunodeficiency with predominantly antibody defects 21.7%, non-familial hypogammaglobulinemia 17.4%, hereditary hypogammaglobulinemia 13%, other specified immunodeficiencies 8.7%, selective immunoglobulin A deficiency 4.3%, unspecified immunodeficiency 4.3%, and other combined immunodeficiencies 4.3%. The median IgG before optimizing therapy was 1108 mg/dL (RIC 142). The cost-saving strategies used were 79.2% dose adjustment, 16.7% total discontinuation, and 4.2% change of treatment. These strategies generated a total savings of $228,538,000 COP (59,624 USD).

CONCLUSIONS: The IgRT optimization strategies used generate a relevant economic impact while maintaining adequate control of the disease.