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Cost-minimization analysis comparing intravenous immunoglobulin with plasma exchange in the management of patients with myasthenia gravis
Julio C. Furlan MD, FRCPC1,*, David Barth MD, FRCPC2, Carolina Barnett MD3 andVera Bril MD, FRCPC3
Article first published online: 26 NOV 2015
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.
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.
PLEX was less costly than IVIg among patients with a body mass index (BMI) > 15.7 kg/m2, 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).
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/m2, from the perspective of a public healthcare insurer.
Muscle Nerve, 2015