Introduction: Since 2010, immunoglobulins (Ig) utilization rate has doubled internationally (NAC & CBS, 2020). Despite efforts since 2018 to make Canada self-sufficient in Ig inventory management, the COVID-19 pandemic emphasized the need to reach this goal (NAC & CBS, 2020). Immunology and neurology are the two most prevalent medical sub-specialties for Ig treatments, neurology being the one that uses the highest volume of Ig products administered to patients in some provinces (INSPQ, 2023). In neurology, generalized myasthenia gravis (gMG) represents the second largest patient population receiving IVIg (INSPQ, 2023). Although various strategies may be implemented to reduce IVIg usage rates in Canada, each province has the mandate of managing its own Ig stocks. As such, there may be disparities between provinces in Ig inventory management initiatives. To inform decision-makers on how to prioritize IVIg usage and establish clear policies to maximize Ig availability to treat patients, clear financial data should be available. Publications have compared treatment costs between IVIg and SCIg (Ritchie et al., 2022), others have retrospectively assessed the costs of IVIg usage (Murphy et al., 2019) over a period of time. However, no systematic pan-Canadian cost assessment of IVIg administration in the hospital ambulatory care setting has been performed. Method: To estimate the cost of hospital ambulatory care IVIg administration, the gMG patient population was selected. From January to March 2024, clinician salaries, medical equipment and hospital overhead costs were compiled for all Canadian provinces and territories. A baseline scenario of chronic gMG patient treatment cycles was established and costs were calculated to compare all health jurisdictions in the country. In addition to direct costs such as salaries and medical supplies, indirect costs such as indirect salaries, energy and infrastructure costs were factored into the final calculations. Results: Salary differences, mainly nursing, and infrastructure costs were the two main elements affecting the IVIg administration cost between provinces. Yearly IVIg treatment costs in hospital ambulatory care settings for one chronic gMG patient may be upward of $9,000 in certain parts of Canada. Discussion: With the availability of alternative treatments to cyclical hospital-based IVIg therapies for chronic gMG patients (CADTH, 2023; CADTH, 2020), health authorities and decision-makers could reallocate significant budgets and move closer to Ig products self-sustainability should they offering this type of treatments in the community. Non-public healthcare patient support programs (PSP) would also further decrease the financial burden of gMG treatments on public healthcare networks.
