Cost-Effectiveness Analysis Of 10% Intravenous Immunoglobulin Compared With Plasma Exchange In Treatment Of Children With Guillain–Barré Syndrome In Russia

OBJECTIVES: To assess the cost-effectiveness of 10% liquid intravenous immunoglobulin (IVIG) (Switzerland) compared with plasma exchange in treatment of Guillain-Barre syndrome (GBS) in children in Russia for 1-year period. METHODS: A decision tree was used to simulate the effects of medicinal drugs and procedures. The data on IVIG and plasma exchange efficacy (measured as ratio of patients with improvement by at least one grade on Hughes functional grading scale for GBS) was obtained from available clinical trials. The following costs were taken into account: ones for IVIG procurement, plasma exchange procedures (including procurement of 5% albumin and consumables), expenditures for SGB treatment, management of adverse events, disability pensions, costs of IVIG administration. As a result, cost-effectiveness ratios (CER) of 10% IVIG (Switzerland) and plasma exchange were calculated. RESULTS: According to van der Meche (the Netherlands,1992) therapy with 10% IVIG (Switzerland) leads to one grade and higher improvement in 19% more patients with SGB compared with plasma exchange procedure. According to performed cost analysis, 10% IVIG (Switzerland) therapy (339,681 rubles/5956 $) is less costly by the end of the 1st year per one patient compared with plasma exchange procedure (408,168 rubles/7,157 $). The calculated CER in USD per 1 % of patients with one grade and more improvement per year was lowest for 10% IVIG (Switzerland) - 640,908 RUB/11,238 $ in comparison with plasma exchange -1,200,495 RUB/21,050 $. Current rate taken as for 15.06.2017 is 1$ = 57,03 RUB. CONCLUSIONS: The treatment of primary immunodeficiencies with 10% liquid intravenous immunoglobulin (Switzerland) is considered cost-effective compared with plasma exchange in children in Russia for 1-year period.