Immunodeficiency is a condition in which the body’s natural defence system, the immune system, is unable to produce sufficient antibodies to fight infection and disease. The condition can be primary, where you are born with it, or secondary, where it’s acquired through infection or as a side effect of a medical treatment.
Standard therapy for primary and secondary immunodeficiency is done in a hospital and consists of receiving regular injections of antibodies, administered into the veins.
Some hospitals are also using a treatment called subcutaneous infusion of immunoglobulin, which involves injecting antibodies into the fatty part of the tissue under the skin. With some training, this treatment can be performed at home by patients or caregivers.
Health Quality Ontario conducted a health technology assessment on home-based subcutaneous infusion versus hospital-based intravenous infusion of immunoglobulin in pediatric and adult populations with primary and secondary immunodeficiencies.
Studies have found that both treatments are comparable in how effective they are; however, patients receiving the home-based treatment reported higher levels of satisfaction. The home-based treatment provides greater convenience and cost savings to patients because of not having to travel to the hospital.
There are also system savings from the home-based treatment, mostly through reduced nursing time. Results suggest that the savings to the health care system would be approximately $5 million over 5 years.
The Ministry of Health and Long-Term Care has accepted this recommendation.
The Ministry of Health and Long-Term Care has provided the following response: The Ministry provides annual funding to Canadian Blood Services, which purchases sub-cutaneous immunoglobulin on behalf of Ontario hospitals. Canadian Blood Services’ procurement agreement ensures subcutaneous immunoglobulin is available to Ontario patients along with the ancillary products and patient training required for home-based treatment.