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Immunoglobulin Therapy: IVIg and SCIg

IVIg · Intravenous SCIg · Subcutaneous

Intravenous immunoglobulin (IVIg) and subcutaneous immunoglobulin (SCIg) are specialty therapies used to treat conditions involving the immune system and nervous system. Accord Specialty Pharmacy provides immunoglobulin therapy with prior authorization support, financial assistance coordination, and doorstep delivery.

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Clinically Reviewed By · Accord Clinical Team, PharmD, RPh

About This Therapy

What Is Immunoglobulin Therapy (IVIg and SCIg)?

Immunoglobulin therapy delivers concentrated antibodies derived from pooled human plasma directly into the body. These antibodies are the same type the immune system naturally produces to fight infection and regulate immune activity. Products are 95 to 98 percent pure IgG antibodies, derived from thousands of individual plasma donations and carefully processed to ensure safety and consistency.2

In patients whose immune system cannot produce adequate antibodies, or in those whose immune system is attacking its own tissue, Ig therapy provides the antibodies the body is missing or helps modulate the immune response. The therapy can be administered in two ways: intravenously (IVIg) or subcutaneously (SCIg), each with different practical implications for patients. The choice between routes depends on the indication, the prescribing physician's clinical judgment, insurance coverage, and patient preference and lifestyle.

Because immunoglobulin therapy is a specialty treatment requiring careful coordination of benefits verification, prior authorization, and ongoing supply management, it is dispensed through specialty pharmacies. Accord manages that process on behalf of patients and their care teams, working with the full range of available IVIg and SCIg products. How Accord supports patients →

FDA-Approved Indications

Conditions Treated with IVIg and SCIg

Immunoglobulin therapy is FDA-approved for a range of neurological and immunological conditions. The specific indication guides which route is appropriate, which products are covered, and how treatment is monitored over time.

Chronic Inflammatory Demyelinating Polyneuropathy

CIDP

A neurological disorder in which the immune system attacks the myelin sheath of peripheral nerves, causing progressive weakness and impaired sensation in the arms and legs. IVIg is a first-line treatment; subcutaneous immunoglobulin is also FDA-approved for CIDP maintenance therapy.1,3

IVIg · SCIg (maintenance)

Primary Immunodeficiency

PI

A group of more than 400 conditions in which the immune system fails to produce adequate antibodies. Immunoglobulin replacement therapy is the standard of care for preventing infection in patients with PI. SCIg is now the most common route for ongoing replacement therapy in the US.2

IVIg · SCIg

Multifocal Motor Neuropathy

MMN

A progressive motor nerve disease causing gradual weakness primarily in the hands and arms. IVIg is the only established treatment for MMN and is typically required on an ongoing basis to maintain function and prevent disease progression.1

IVIg

Myasthenia Gravis

MG

An autoimmune condition in which antibodies block or destroy receptors at the neuromuscular junction, causing muscle weakness that worsens with activity. IVIg is used during exacerbations or as a bridge to other immunosuppressive therapies.

IVIg

Guillain-Barré Syndrome

GBS

An acute condition in which the immune system attacks peripheral nerves, causing rapidly progressive weakness that can affect breathing. IVIg is one of two primary treatments — alongside plasma exchange — used to shorten the duration and severity of the illness.1

IVIg (acute)

Immune Thrombocytopenia

ITP

An autoimmune condition causing low platelet counts and increased bleeding risk. IVIg is used to temporarily raise platelet counts, often in preparation for surgery or during acute bleeding episodes. For long-term ITP management, see our Promacta (eltrombopag) page.

IVIg (short-term)

Inflammatory Myopathies

Dermatomyositis · Polymyositis

Inflammatory diseases affecting the muscles — including dermatomyositis and polymyositis — may be treated with IVIg when other therapies have not been sufficiently effective. Use is typically adjunctive alongside other immunosuppressive agents.

IVIg

Your physician is the right person to determine whether immunoglobulin therapy is appropriate for your diagnosis and which route of administration best fits your clinical situation.

Route of Administration

IVIg vs. SCIg: Understanding Your Options

Both routes deliver the same type of antibodies and can achieve comparable clinical results in many indications. The practical experience of treatment differs significantly between the two. Understanding these differences helps patients have more informed conversations with their care team.

Intravenous

Intravenous Immunoglobulin (IVIg)

Frequency Every 3–4 weeks per infusion cycle
Setting Infusion center, hospital outpatient, or home with a visiting nurse

Advantages

  • Less frequent schedule — managed monthly rather than weekly
  • Familiar clinical setting with nursing oversight at each infusion
  • Reaches peak IgG levels quickly after infusion, useful in certain acute situations
  • No self-injection required

Considerations

  • Venous access required for each infusion
  • Each session typically lasts several hours
  • Higher likelihood of systemic reactions (headache, fever, chills) compared to SCIg
  • Vital signs monitored during infusion
Subcutaneous

Subcutaneous Immunoglobulin (SCIg)

Frequency Weekly or biweekly; lower volume per session
Setting Home self-administration after training; no IV access required

Advantages

  • Home administration without IV access
  • More stable IgG levels between doses (less fluctuation than IVIg)
  • Generally fewer systemic reactions; often better tolerated
  • Compatible with active lifestyles for many patients

Considerations

  • More frequent administration schedule
  • Local injection site reactions (redness, swelling, itching) — usually mild
  • Requires sufficient dexterity and confidence to self-administer
  • Some insurance plans require a trial of IVIg before approving SCIg

The choice between IVIg and SCIg involves the clinical indication, venous access, lifestyle, insurance coverage, and patient preference. Some indications are approved for both routes; others are currently approved only for IVIg. Your prescriber and our team can work through these factors together to identify the right path for your situation. Learn more about how we support patients →

Safety Information

IVIg Side Effects and Long-Term Considerations

The nature of side effects differs meaningfully between IVIg and SCIg. Understanding what to expect can help patients and caregivers prepare and know when to contact their care team. The information below is not a complete list — review the full prescribing information for your specific product with your care team.

IVIg Side Effects Intravenous

Most Common

Infusion Reactions and Common Effects2

  • Headache — the most frequently reported side effect; often managed with pre-medication (acetaminophen, antihistamines, or corticosteroids given before the infusion), a slower infusion rate, and adequate hydration
  • Fever and chills — infusion-related reactions typically occurring during or shortly after the infusion; usually resolving within a day or two
  • Nausea and fatigue — commonly reported around the time of infusion; staying well hydrated may help manage these symptoms
  • Muscle aches — reported by many patients in the hours following infusion; typically mild and self-limiting
Serious

Serious Considerations2

  • Aseptic meningitis syndrome — a severe headache with neck stiffness and sensitivity to light, occurring within hours to two days of infusion; seek immediate medical attention if these symptoms develop
  • Blood clots (thrombosis) — risk is elevated particularly in patients with existing cardiovascular risk factors; your prescriber monitors for this, especially when starting or adjusting doses
  • Kidney effects — IVIg can affect kidney function; monitoring is standard, particularly at initiation or during significant dose changes
  • Hemolysis — some IVIg products can cause red blood cell destruction; monitored through routine lab work throughout treatment

SCIg Side Effects Subcutaneous

Most Common

Local Injection Site Reactions2

  • Redness, swelling, warmth, or itching at the infusion site — typically mild and resolving within 24 hours; frequency often decreases as patients gain experience with self-administration
  • Minor infusion discomfort — occasional mild burning or pressure at the injection site during administration; usually resolves as the infusion completes
  • Systemic reactions less common than with IVIg — headache and other systemic effects are reported less frequently with SCIg; most patients find this route better tolerated overall
Ongoing

Technique and Long-Term Considerations2

  • Site rotation — rotating injection sites across the abdomen, thighs, and upper arms reduces the likelihood of persistent local reactions; your training will cover site selection and rotation schedules
  • Administration training — proper self-administration technique is essential for SCIg safety and tolerability; your care team provides training before you begin home infusions
  • IgG trough monitoring — your immunologist or neurologist will check IgG blood levels periodically to confirm your dose is maintaining therapeutic levels

If anything concerns you during or after an infusion, contact your prescribing physician promptly. Our pharmacy team can be reached at 1-855-222-6730.

Prior Authorization for IVIg and SCIg

Most insurance plans require prior authorization before covering immunoglobulin therapy. For Ig therapy, the PA process typically involves documentation of the specific diagnosis, laboratory results supporting the indication (such as IgG levels for PI or nerve conduction studies for CIDP), prior treatments that have been tried, and the clinical rationale for the specific product and route prescribed. Documentation requirements vary by indication and payer.

Some insurance plans require a trial of IVIg before approving SCIg — particularly for PI patients. If this applies to your coverage, our team and your prescriber can work together to document the clinical case for the route that is right for you. When Accord receives your referral, we contact your care team to gather what the insurance plan requires, submit the prior authorization, and follow up until a decision is reached. If your plan issues a denial, we work alongside your prescriber to build a formal appeal. Information for prescribers →

Prior Authorization Process

1

Referral Received

We receive your referral from your prescriber by fax or online referral form

2

Benefits Verified

We confirm your insurance coverage, route authorization, and any product-specific requirements

3

PA Submitted

Prior authorization submitted to your insurance plan with clinical documentation from your prescriber

4

Appeal if Denied

We work alongside your prescriber to build a formal appeal with additional supporting documentation

Note on appeals: A denial is not necessarily final. Many initially denied requests for Ig therapy are approved on formal appeal with the right clinical documentation. Our team manages this process alongside your prescriber.

IVIg Cost and Financial Assistance

IVIg cost is among the highest of any specialty medication category. Unlike most medications where one manufacturer covers one drug, immunoglobulin therapy involves multiple brand products from multiple manufacturers — each with its own patient assistance and copay support programs. The right program for any patient depends on which specific product is prescribed, their insurance, and their income situation. Our team actively researches which programs apply and assists with the enrollment process.

Grifols Products

Grifols Cares Patient Support

Varies based on product and coverage

Grifols Cares supports patients on Gammagard Liquid, Gamunex-C, Flebogamma, and Xembify — including copay assistance for commercially insured patients and patient assistance for uninsured or underinsured patients meeting income guidelines. Our team assists with the enrollment process.4

CSL Behring Products

Privigen and Hizentra Patient Support

Varies based on product and coverage

CSL Behring's patient support programs cover Privigen (IVIg) and Hizentra (SCIg). The MySCIG program for Hizentra includes training support and patient assistance for home self-administration. Copay assistance is available for eligible commercially insured patients. Our team assists with the enrollment process.5,6

Independent Assistance

Disease-Specific Foundations

Grants Available based on condition and fund availability

The Immune Deficiency Foundation, GBS/CIDP Foundation International, National Organization for Rare Disorders (NORD), PAN Foundation, and HealthWell Foundation may provide supplemental financial assistance for Ig therapy indications. Our team identifies programs and helps connect you to foundations that are currently accepting applications.

Medicare

Part B and Part D Coverage

$2,100 Cap 2026 Part D annual out-of-pocket maximum

IVIg administered in an infusion center or by a home infusion nurse is typically covered under Medicare Part B. SCIg products used at home may fall under Part D depending on the specific product. The 2026 Part D annual out-of-pocket cap provides meaningful protection for patients on long-term Ig therapy. Our team can help clarify how your specific coverage applies.

Reach out before assuming this therapy is unaffordable. Call 1-855-222-6730 or contact us online — our team identifies what you qualify for and assists with enrollment.

Getting Started

Getting Started with IVIg or SCIg Through Accord

01

Referral Sent

Your prescriber sends a referral to Accord by fax or online referral form.

02

Insurance Verified

We confirm your coverage, route authorization, and any product-specific benefits requirements.

03

Prior Authorization

We submit clinical documentation and manage the PA process on your behalf.

04

Financial Assistance

We identify programs that may apply to your product, coverage, and income situation and help connect you to the right resources.

05

Doorstep Delivery

Your medication ships directly to your door in states where Accord is licensed.

Treatment Expectations

How to Tell If IVIg Is Working

One of the most common questions patients have — particularly in the early months of treatment — is whether the therapy is actually doing what it is supposed to do. The answer depends on the indication, because what "working" looks like differs for each condition.

Neurological Conditions

CIDP, MMN, and Related Diagnoses

The primary goal of IVIg in neurological conditions is to slow or halt disease progression and, in many cases, improve function that has already been affected. Signs that treatment may be working include improved muscle strength, better balance and coordination, reduced numbness or tingling in the hands and feet, and a stabilization of symptoms that were previously worsening. Response in CIDP can continue to develop over multiple infusion cycles — nerve healing is a slow process. Your neurologist will use formal assessments of strength and function to track your response objectively.

Primary Immunodeficiency

Replacement Therapy

The clearest sign that Ig therapy is working for PI is a reduction in the frequency, severity, and duration of infections compared to before treatment began — fewer hospitalizations, fewer antibiotic courses, and an overall improvement in daily health and quality of life. Your immunologist will monitor IgG trough levels just before your next infusion to confirm that therapeutic levels are being maintained between doses.

Acute Indications

GBS, ITP, and Acute Exacerbations

In acute settings, the response to IVIg is often more rapidly apparent — improvement in platelet counts within days for ITP, or accelerated neurological recovery in GBS. For many chronic conditions, the most important role of IVIg is preventing further deterioration. Stability — holding a baseline rather than declining — is a meaningful and valid treatment outcome. If you are uncertain whether your therapy is providing benefit, the right conversation to have is with your prescribing physician.

If you are uncertain whether your therapy is providing benefit, discuss it with your prescribing physician. Our pharmacy team can be reached at 1-855-222-6730 with questions about your treatment.

IVIg and SCIg Brands

IVIg and SCIg Brands Available at Accord

Accord dispenses the full range of FDA-approved immunoglobulin products. All products are 95 to 98 percent pure IgG and derived from pooled human plasma, but they differ in concentration, approved route of administration, stabilizers, and specific approved indications. Your prescriber and care team select the appropriate product based on your diagnosis, clinical history, and insurance coverage.

IVIg and SCIg

Gammagard Liquid

Grifols

One of the most widely used immunoglobulin products in the United States, Gammagard Liquid is a 10% IgG formulation approved for both intravenous and subcutaneous administration. Indicated for primary immunodeficiency; frequently used for CIDP and other neurological conditions. The dual-route approval offers flexibility when clinical needs or coverage changes. Patient support is available through the Grifols Cares program.

IVIg

Privigen

CSL Behring

Privigen is a 10% IgG formulation approved for primary immunodeficiency and ITP in adults, and widely used for neurological indications including CIDP. One of the most frequently dispensed IVIg products in specialty pharmacy practice. Copay assistance is available for eligible commercially insured patients through CSL Behring's patient support program.

SCIg

Hizentra

CSL Behring

Hizentra is a 20% IgG formulation designed exclusively for subcutaneous administration, approved for primary immunodeficiency and as maintenance therapy for CIDP — one of the only SCIg products with a CIDP maintenance indication. Administered weekly at home using a portable pump after training. CSL Behring's MySCIG program provides training support and patient assistance resources.

Intravenous Immunoglobulin (IVIg) Products — 13 Brands
Brand Manufacturer Concentration Notes
Alyglo Octapharma 10%
Asceniv ADMA Biologics 10% Contains enhanced levels of RSV antibodies
Bivigam ADMA Biologics 10%
Flebogamma DIF Grifols 5% / 10%
Gamastan Grifols 15–18% Intramuscular administration; specific prophylactic indications only
Gammagard Liquid Grifols 10% Also approved for subcutaneous (SCIg) use
Gammaked Grifols 10% Also approved for subcutaneous (SCIg) use
Gammaplex BPL Plasma 5% / 10%
Gamunex-C Grifols 10% Also approved for subcutaneous (SCIg) use
Octagam Octapharma 5% / 10%
Panzyga Octapharma 10%
Privigen CSL Behring 10%
Yimmugo Kedrion 10%

Subcutaneous Immunoglobulin (SCIg) Products — 6 Brands
Brand Manufacturer Concentration Notes
Cutaquig Octapharma 16.5%
Cuvitru Takeda 20%
Hizentra CSL Behring 20% Approved for PI and CIDP maintenance therapy
Hyqvia Takeda 10% Co-formulated with recombinant human hyaluronidase; allows larger subcutaneous volume; less frequent dosing schedule
Qivigy Kedrion 10%
Xembify Grifols 20%

Common Questions About IVIg and SCIg

Does Accord Specialty Pharmacy provide IVIg and SCIg?

Yes. Accord is a licensed specialty pharmacy that dispenses the full range of FDA-approved immunoglobulin products for both IVIg and SCIg therapy. We manage prior authorization, financial assistance coordination, and doorstep delivery for all products we carry.

How do I get started on IVIg or SCIg through Accord?

Your prescriber can send a referral directly to Accord using our referral form, or by faxing to 386-456-3000. You can also call us at 1-855-222-6730 and our team will walk you through the process.

How much does IVIg cost?

IVIg cost varies significantly based on the specific product, the prescribed dose, and your insurance coverage. At list price, immunoglobulin therapy is among the most expensive specialty medication categories. However, manufacturer assistance programs, independent foundation grants, and insurance coverage — including Medicare Part B for infusion center administration — can substantially reduce what patients actually pay. Contact our team and we will review your specific situation before your first fill.

Is there financial assistance for IVIg or SCIg?

Yes, though the programs are fragmented across multiple manufacturers. Each brand has its own patient support and copay assistance programs with different eligibility criteria. Our team actively researches which programs apply to your specific product, insurance, and income situation. Call us at 1-855-222-6730 and we will identify every program you may qualify for.

What is the difference between IVIg and SCIg?

IVIg is given through an IV line, typically every three to four weeks at an infusion center or at home with nursing support. SCIg is administered under the skin — usually weekly or biweekly — and most patients self-administer at home after training. Both deliver the same antibodies; the key differences are frequency, administration setting, and side effect profile. See the route comparison section above for a full breakdown.

Is IVIg home infusion available?

Home IVIg infusion is available for some patients with appropriate venous access and a prescriber's order, typically administered by a visiting infusion nurse. SCIg self-administration at home is available for most patients and is the most common arrangement for ongoing SCIg therapy. Our team can help clarify which home administration options apply to your situation.

How long does prior authorization take for IVIg?

Timelines vary by insurance plan and indication. Ig therapy prior authorization typically requires more clinical documentation than most other specialty medications — including IgG levels, diagnosis confirmation, and sometimes documentation of prior treatment. Our team begins working on your prior authorization as soon as we receive your referral and follows up proactively. We keep both you and your prescriber updated throughout.

What if my insurance denies IVIg, or requires IVIg before SCIg?

Denials and route restrictions both occur with Ig therapy. Our team works alongside your prescriber to submit a formal appeal with the clinical documentation needed to support your case — including documentation of why a specific route or product is clinically appropriate for you. Many initially denied requests are approved on appeal.

For Patients

Ready to Get Started?

Our team coordinates everything — insurance verification, prior authorization, financial assistance, and delivery. Call us or ask your prescriber to send a referral, and we take it from there.

Call 1-855-222-6730

For Prescribers

Refer a Patient to Accord

Download the immunoglobulin therapy referral form, complete all sections, and fax to 386-456-3000. We confirm receipt within one business day and manage prior authorization on your behalf.

Download Referral Form

Explore More

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References (6)
  1. National Institute of Neurological Disorders and Stroke. Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) Information Page. National Institutes of Health. ninds.nih.gov
  2. Immune Deficiency Foundation. Immunoglobulin Replacement Therapy. primaryimmune.org
  3. GBS/CIDP Foundation International. About CIDP. gbs-cidp.org
  4. Grifols. Supporting Patients. grifols.com/en/supporting-patients
  5. CSL Behring. Privigen Patient Support. cslbehring.com
  6. CSL Behring. Hizentra MySCIG Patient Support Program. hizentra.com
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