Drug Use Evaluation of Intravenous Immunoglobulin (IVIG) in Imam Reza Hospital, affiliated to Tabriz University of Medical Sciences, 2016-2017

Abstract

Introduction: Drug use evaluation (DUE) aims at improving the patients’ care. Studying the administration pattern of intravenous immunoglobulin (IVIG) is necessary for the rational prescriptions due to limited availability and high cost. Aim: This combined retrospective and prospective study was conducted at Imam Reza's hospital, to investigate the prescription and administration pattern of IVIG. Methods: This combined retrospective and prospective study conducted at Imam Reza's hospital in Tabriz, six months from 2016 to 2017. Patients receiving IVIG at Imam Reza's hospital in Tabriz were investigated during the course of the study. To do so, the related information was collected. The information includes patient's demographics, indications, drug use regimen and side effects. The results were compared to the available standards on the prescription and administration of IVIG. Therefore, patients were divided in three main groups, FDA approved, Off-labeled with support and Off-labeled without support. Results: In this study, 90 patients with an average age of 51.6 years (10 years to 83 years) were studied. IVIG was administered in 26 patients (28.9%) for FDA-approved indications, in 57 patients (63.3%) for off-labeled with support items and in 7 patients (7.8%) for off-labeled without support cases. The total amount of IVIG used in this study was g10580, which cost 15870000000 Rials. 6.1% of the total cost was spent on off-labeled without support group, which is equivalent to 975000000 Rials. . Conclusion: As regards the high costs of IVIG, complications, and lack of enough information on the quality of the effect of this drug in the treatment of some cases, physicians should be cautious enough with its appropriate use. More than 92% of IVIG use in the study period was in accordance with the standard guidelines. It seems that there is a good overview of the IVIG use from clinical pharmacists of the Imam Reza's hospital.