OBJECTIVES:

Guillain-Barré syndrome (GBS) is a rapid-onset muscle weakness caused by the immune system damaging the peripheral nervous system. The disease can be treated with Therapeutic Plasma Exchange (TPE) or with intravenous immunoglobulin (IVIG). Among neurologists and hospital executives, there is uncertainty about what is the most cost-efficient treatment for GBS. The intent of this research is to assess the latest insights on the cost-efficiency of TPE versus IVIG in the treatment of GBS.

METHODS: A systematic literature review was performed on the cost-efficiency of TPE in GBS by means of searches on PubMed as well as through the ISPOR Scientific Presentations Database. Publications were collected between 1999 and 2017.

RESULTS: Fifteen relevant publications were identified between 1999 and 2017. In 11 out of the 15 cases, TPE was more cost-efficient than IVIG; in 3 cases, the studies were undecided; and in 1 case, IVIG was more cost-efficient than TPE. When TPE was more cost-efficient than IVIG, hospital costs were 53% lower on average. A weighted average across all publications showed potential average savings of 38% of hospital costs. The actual treatment costs largely depended on the severity of the disease, the hospital type, patient characteristics (for example, body mass index), and the country where the study was performed (data on file).

CONCLUSIONS:

Assuming equality in terms of patient characteristics and hospital type, TPE is more cost-efficient in the treatment of GBS than IVIG most of the time. In terms of the total treatment costs, savings between 15% and 83% are possible when TPE is applied versus IVIG. Health systems that foresee an increased use of TPE versus IVIG in the treatment of GBS are likely to experience cost savings.