title: Cost-minimization analysis comparing intravenous immunoglobulin with plasma exchange in the management of patients with myasthenia gravis.
abstract: 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/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).
  
  
  
  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.
authors.affiliation: Department of Medicine, Division of Physical Medicine and Rehabilitation, Lyndhurst Centre, Toronto Rehabilitation Institute, 520 Sutherland Drive, Room 205, Toronto, Ontario, M4G 3V9, Canada.
authors.forename: Julio C
authors.initials: JC
authors.lastname: Furlan
authors.affiliation: Department of Medicine, Division of Hematology, University of Toronto, Toronto, Ontario, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Barth
authors.affiliation: Division of Neurology, University Health Network, Toronto, Ontario, Canada.
authors.forename: Carolina
authors.initials: C
authors.lastname: Barnett
authors.affiliation: Division of Neurology, University Health Network, Toronto, Ontario, Canada.
authors.forename: Vera
authors.initials: V
authors.lastname: Bril
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000191:economics* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000191:economics* / Q000628:therapy*; D010951:Plasma Exchange / Q000191:economics* / Q000379:methods*; D018709:Statistics, Nonparametric; D055815:Young Adult
chemical_list: D016756:Immunoglobulins, Intravenous
keywords: cost-minimization analysis; intravenous immunoglobulin; myasthenia gravis; neuromuscular junction disease; plasma exchange