To identify the frequency of insurance related issues with intravenous immunoglobulin (IVIg) therapy approval for patients with autoimmune gastrointestinal dysmotility (AGID) and the outcomes of missed IVIg treatments.

AGID is a rare neurological disorder causing autoimmune dysautonomia and altered gastrointestinal transit. IVIg therapy has been shown to improve patients' symptoms, scintigraphy results, and autonomic testing (Flanagan et al, 2014). Unfortunately, patients constantly battle with insurance leading to delayed or cessation of treatment.

We retrospectively reviewed 20 AGID patients treated with IVIg. We collected smart pill data, neurological test results, serology, patient outcomes, reasons for stopping or missing IVIg, and insurance denials and halts. Patient outcomes included objective repeat serology titers and subjective patient reported symptoms.

13/20 patients (65%) experienced insurance issues leading to IVIg treatment delay or cessation. 9 of these 13 patients with insurance issues were initially denied IVIg therapy with the average delay in therapy taking 2.8 months (SD = 2.9). Some approvals took a month while others took more than 4 months (longest being an 8-month delay). 4 of these 9 patients had continued insurance issues after being initially denied causing them to miss treatments. 6/13 patients had initial symptom improvement but experienced a relapse from missing IVIg treatments.

Patients with AGID suffer when they miss IVIg treatments. Early and continued insurance approval is vital for the outcomes of these patients.