Comment on “Pharmacoeconomics of therapy for Guillain-Barré syndrome: plasma exchange and intravenous immunoglobulin”

Buenz, Eric J.

doi:10.1016/j.jocn.2008.11.004

Cited by 2 publications

(2 citation statements)

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“…They concluded that despite the significantly lower cost for TPE, total costs were lower in the IVIg group [37]. In a response to the study, Buenz raised several critical questions [38]. While the age difference between the two groups was not statistically significant, Buenz suggested that the difference between an 83-year-old and a 45 year-old-patient (statistically equally as probable according to the data presented where the 95% confidence interval for the age difference is -5.12 to 38.5 years) is clinically significant with regard to GBS prognosis, regardless of the therapeutic intervention [38].…”

Section: Discussionmentioning

confidence: 99%

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Cost-minimization analysis of the direct costs of TPE and IVIg in the treatment of Guillain-Barré syndrome

Winters

Brown²,

Hazard³

et al. 2011

BMC Health Serv Res

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BackgroundControlled trials have found therapeutic plasma exchange (TPE) and intravenous immunoglobulin (IVIg) infusion therapy to be equally efficacious in treating Guillain-Barré syndrome (GBS). Due to increases in the price of IVIg compared to human serum albumin (HSA), used as a replacement fluid in TPE, we examined direct hospital-level expenditures for TPE and IVIg for meaningful cost-differences between these treatments.MethodsUsing financial data from our two institutions, hospital cost profiles for IVIg and 5% albumin were established. Reimbursement amounts were obtained from publicly available Medicare data resources to determine payment rates for TPE, non-tunneled central catheter line placement, and drug infusion therapy. A model was developed which allows hospitals to input cost and reimbursement amounts for both IVIg and TPE with HSA that results in real-time valuations of these interventions.ResultsThe direct cost of five IVIg infusion sessions totaling 2.0 grams per kilogram (g/kg) body weight was $10,329.85 compared to a series of five TPE procedures, which had direct costs of $4,638.16.ConclusionsIn GBS patients, direct costs of IVIg therapy are more than twice that of TPE. Given equivalent efficacy and similar severity and frequencies of adverse events, TPE appears to be a less expensive first-line therapy option for treatment of patients with GBS.

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Section: Discussionmentioning

confidence: 99%

“…The assertion that TPE is more expensive than IVIg is based on this single patient with sepsis where the nature and source of the infection is unreported. While the study provides an important contribution to the literature on TPE and IVIg, it raises concerns that require additional research [38]. …”

Section: Discussionmentioning

confidence: 99%