Praiseldy Langi Sasongko

136 Chapter 3 Supplementary Table 4: Miscellaneous but important factors From literature From interviews Societal factors • Supply issues, interrelated to logistical factors of contract fractionation and recruiting/retaining plasma donors • Freedom of choice: having branding and application options to choose from • Increasing usage of SCIg or facilitated SCIg (fSCIg) • Sufficient plasma donors • Marketing/organizational strategies to obtain donors • (Non)-remuneration of donors • Ensuring the (positive) reputation of organization Technological factors • Optimized use of plasma-derived proteins • Production factors: Technological changes to have greater yield in the same pool of plasma Economic/ political/ legal factors • Using subcutaneous immunoglobulins (SCIg) could be substantially cost-saving for multiple parties involved31,62,63 although the impact on demand is yet unknown due to dosing differences • Supply issues, interrelated to factors of contract fractionation, access issues, donor remuneration, and self-sufficiency • • Reimbursement issues, related to the pricing of products, and barriers from patients and insurance companies • Price-setting of Ig products • Market sizes of different countries for Ig products (and these products being diverted to the more lucrative markets) • Dependency on U.S. plasma • Specific governmental regulations • Competition within the pharmaceutical industry and consequential supply issues • Substantial power of commercial companies • High rate of off-label usage

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