Result card

  • ETH13: Does the economic evaluation of IGG contain any ethical problems?
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Does the economic evaluation of IGG contain any ethical problems?

Authors: Plamen Dimitrov, Anelia Koteva

Internal reviewers: Pseudo99 Pseudo99

Each new therapeutic technology is introduced as a routine clinical practice after indisputable evidence in favor of patients and following a detailed economic assessment of the efficiency of various treatment schemes (dose, frequency, duration). In an experimental study on intravenous infusion of immunoglobulins in patients with Alzheimer’s disease were tested different therapeutic regimens for 36 months. The following schemes were applied: 0.2 g/kg every 2 weeks; 0.4 g/kg every 2 weeks; 0.4 g/kg every 4 weeks, and 0.8 g/kg every 4 weeks.[1]

 

The results from the randomized clinical trials conducted on very few patients, some of whom got complications during the experiment, show a trend towards improvement in the IVIG-treated individuals compared to the placebo group. Although to date no final selection of the most appropriate therapeutic regimen could be made, treatment is known to be quite expensive.

 

The price is above USD 75 per gram (i.e. approximately USD 15000 per infusion with a patient’s weight about 100 kg and the therapy being administered in the lowest possible dose – 2g/kg).[2] Given the conflicting results of the trials and the small number of treated patients, researchers are too cautious when recommending an official introduction of immunoglobulin therapy for AD patients, highlighting the fact that this would deprive other needy patients of the only possible treatment for their disease.

 

[1] Gever, J., “IVIG Stops Alzheimer’s in Its Tracks”, published on 17th July 2012, available at: http://www.medpagetoday.com/MeetingCoverage/AAIC/33780 .

[2]Intravenous Immunoglobulin”, Wikipedia, available at: http://en.wikipedia.org/wiki/Intravenous_immunoglobulin .

Dimitrov P, Koteva A Result Card ETH13 In: Dimitrov P, Koteva A Ethical analysis In: Jefferson T, Cerbo M, Vicari N [eds.]. Use of Intravenous immunoglobulins for Alzeheimer’s disease including Mild Cognitive Impairment [Core HTA], Agenas - Agenzia nazionale per i servizi sanitari regionali ; 2015. [cited 24 October 2020]. Available from: http://corehta.info/ViewCover.aspx?id=267