Indikationen für den Einsatz von Immunglobulinen

Fortschritte in der Medizin, aber auch zunehmende ökonomische Überlegungen, machen eine regelmäßige Diskussion der Indikationen für Immunglobuline erforderlich. In den letzten Jahren ist es zu einem Mangel an Immunglobulinpräparaten gekommen, unter anderem bedingt durch den vermehrten Einsatz von Immunglobulinen in den Vereinigten Staaten von Amerika sowie durch vermehrte zulassungsüberschreitende Anwendung (sog. „Off-Label-Use”) insbesondere in der Neurologie. Zudem hat das Bundessozialgericht in Kassel am 19.03.2002 ein Urteil zur Kostenerstattung für „Off-Label”-Verordnungen gefällt, das auch, aber nicht nur, für den Einsatz der kostenintensiven Immunglobulintherapie von Bedeutung ist. Nach diesem Urteil müssen für den Einsatz eines Präparates außerhalb der zugelassenen Anwendungsgebiete streng definierte Bedingungen erfüllt sein (siehe Anhang). Am 28.10.2002 fand an der Medizinischen Hochschule Hannover eine Konsensuskonferenz zum Einsatz von Immunglobulinen statt. Nachfolgend werden die wichtigsten Ergebnisse dieser Konferenz zur Immunglobulintherapie vorgestellt.

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