Cost-minimization analysis comparing intravenous immunoglobulin with plasma exchange in the management of patients with myasthenia gravis

Muscle Nerve. 2016 Jun;53(6):872-6. doi: 10.1002/mus.24960. Epub 2015 Nov 26.

Abstract

Introduction: Myasthenia gravis (MG) exacerbations may be treated with intravenous immunoglobulin (IVIg) or plasma exchange (PLEX), which have equivalent effectiveness. This cost-minimization analysis compared IVIg with PLEX for treatment of patients with MG exacerbation.

Methods: We combined the Ontario-based health cost data with clinical data from a randomized clinical trial. Analyses were undertaken from the perspective of a public healthcare insurer and from the perspective of a tertiary university hospital payer.

Results: PLEX was less costly than IVIg among patients with a body mass index (BMI) > 15.7 kg/m(2) , from the perspective of the public healthcare insurer (P < 0.0001). However, PLEX was more costly than IVIg from the perspective of the hospital payer when the costs of blood products were excluded (P < 0.0001).

Conclusions: PLEX can be considered a short-term cost-minimizing therapy when compared with IVIg for treatment of MG exacerbation among patients with BMI >15.7 kg/m(2) , from the perspective of a public healthcare insurer. Muscle Nerve 53: 872-876, 2016.

Keywords: cost-minimization analysis; intravenous immunoglobulin; myasthenia gravis; neuromuscular junction disease; plasma exchange.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Costs and Cost Analysis
  • Female
  • Humans
  • Immunoglobulins, Intravenous / economics*
  • Immunoglobulins, Intravenous / therapeutic use*
  • Male
  • Middle Aged
  • Myasthenia Gravis / economics*
  • Myasthenia Gravis / therapy*
  • Plasma Exchange / economics*
  • Plasma Exchange / methods*
  • Statistics, Nonparametric
  • Young Adult

Substances

  • Immunoglobulins, Intravenous