OBJECTIVES

Therapeutic plasma exchange (TPE) is applicable in a variety of clinical indications. It can be performed through centrifugal systems (cTPE) and membrane devices (mTPE). Both come with different costs, adverse events, procedure times and plasma removal efficiency. The objective of this study is to perform a cost benefit analysis comparing cTPE and mTPE through the lens of a health system payer.

METHODS

Drivers of cost and actual cost data were collected through a systematic literature review on PubMed and the ISPOR Scientific Presentations Database. All retrieved costs were adjusted and discounted for the year 2018.

RESULTS

In terms of health outcomes related to the primary indication of treatment, cTPE and mTPE demonstrated equal effectiveness. The most important cost drivers identified for both TPE systems were: device acquisition costs, maintenance costs, disposable costs, procedure/staff time, plasma replacement fluids, catheter type (central vs peripheral), clotting events, and the costs of adverse events. On a basis of 250 TPE procedures during a single year the total cost for the health system payer was € 172 lower for cTPE vs mTPE. Resulting in a potential yearly saving of € 43.000 per hospital unit where TPE is performed. In terms of staff time 6 weeks of FTE time per year could be saved by favoring cTPE over mTPE.

CONCLUSIONS

In the above tested scenario, centrifugal TPE had a better cost benefit ratio than membrane TPE. Increased utilization of cTPE versus mTPE is likely to results in cost savings for apheresis units and their payers.