Abstract
Introduction: Guillain Barre Syndrome is considered one of the most important causes of acute neuromuscular paralysis. Currently there are two clinically effective therapies for the treatment of disease: IVIG and plasmapheresis.
Objective: To estimate which therapy is less expensive for the in-hospital care of patients diagnosed with moderate to severe Guillain Barre in the Fundación Cardioinfantil of Bogotá, Colombia.
Materials and Methods: All patients that were discharged between January and December 2014 with GuillainBarre syndrome diagnosis were included. The cost information for each patient was provided by department of medical bills and the total cost of care was established from admission to patient discharge. The comparison of the total costs of care of patients treated with IVIG vs. patients treated with plasmapheresis was performed by means of the Mann-Whitney analysis.
Results: The cost of care of patients with intravenous immunoglobulin was 9,976 USD while the total cost of patients with plasmapheresis was 23,354 USD. The higher cost of care in this last group of patients was driven by the increased number of complications arising from the same treatment.
Conclusion:Between the two treatments considered in the advanced states of Guillain Barre Syndrome, IVIG offers an adequate strategy to minimize the cost of hospital patient care in patients with a diagnosis of Guillain-Barre syndrome in the Fundación Cardioinfantil of Bogotá.
References
Van den Berg B, Walgaard C, Drenthen J, Fokke C, Jacobs BC, Van Doon PA. Guillain- Barré syndrome: pathogenesis, diagnosis, treatment and progonosis. Nat. Rev. Neurol. 2014; 10(8):469–482.
Van Doorn PA.L & Jacobs, B.C. Clinical features, pathogenesis, and treatment of Guillain Barré syndrome. Lancet neurol. 2008; 7(10):939-950.
Hughes RAC, Swan AV, van Doorn PA. Intravenous immunoglobulin for Guillain-Barré syndrome. Cochrane Database Syst Rev. 2012;11(7):6.
Winer JB. Guillain-Barre syndrome. Mol Pathol. 2001;54(6):381–385.
Mori M, Kuwabara S. Fisher Syndrome. Curr. Treat Options Neurol. 2011;13 (1):71-78.
Fokkin WJ, Selman MH, Dortland JR, Durmus B, Kuitwaard K, Huizinga R, et al. IgG fc N-glycosylation in Guillain Barré syndrome treated with inmunoglobulins. J. Proteome Res. 2014;13(3):1722–1730.
No author listed. Randomised trial of plasma exchange, intravenous immunoglobulin, and combined treatments in Guillain Barré syndrome. Plasma exchange Sandoglobulin Guillain Barre syndrome Trial Group. Lancet. 1997; 349 (9047):225-230.
Ansar V, Valadi N. Guillain Barré Syndrome. Prim Care. 2015;42(2):189-193.
Kuwabara S, yuki N. Axonal Guillain Barré syndrome: concepts and controversies. Lancet Neurol. 2013;12(12):1180 1188.
Lin JH, Tu KH, Chang CH, Chen yC, TianyC, Yu CC, et al. Prognostic factors and complication rates for double-filtration plasmapheresis in patients with Guillain-Barré syndrome. Transfus Apher Sci. 2015; 52(1):78-83.
Van der Meché FG, Schmitz PI. A Randomized Trial Comparing Intravenous Immune Globulin and Plasma Exchange in Guillain-Barré Syndrome. Dutch Guillain Barré Study Group. N Engl J Med.1992;326(17):1123-1129.
Winters JL, Brown D, Hazard E, Chainani A, Andrzejewski C Jr. Cost-minimization analysis of the direct costs of TPE and IVIg in the treatment of Guillain-Barré syndrome. BMC Health Serv Res. 2011;11:101.
Visser LH, Schmitz PI, Meulstee J, van Doorn PA, van der Meché FG. Prognostic factors of Guillain-Barré syndrome after intravenous immunoglobulin or plasma exchange. Dutch Guillain-Barré Study Group. Neurology. 1999;53(3):598-604.
Banrep.gov.co (Internet). Colombia: Banco Central de la República de Colombia; 2016. Disponible en: http://www.banrep.gov.co/es/trm.
Hughes RA, Newson-Davis JM, Perkin GD, Pierce JM. Controlled trial prednisolone in acute polyneruopathy. Lancet. 1978;2(8093):750-753.
Nagpal S, Benstead T, Shumak K, Rock G, Brown M, Anderson DR. Treatment of Guillain-Barré syndrome: a cost-effectiveness analysis. J Clin Apher. 1999;14 (3):107-13.
Tsai C, Wang K, Liu C, Sheng W, Lee T. Pharmacoeconomics of therapy for Guillain-Barré syndorme: plasma exchange and inravenous immunoglobulin, J Clin Neurosci. 2007;14(7):625 629.
Oczko-Walker M, Manousakis G, Wang S, Malter JS, Waclawik AJ. Plasma exchange after initial intravenous immunoglobulin treatment in Guillain-Barré Syndrome: Critical reassessment of effectiveness and costo-efficiency. J clin neuromuscul dis. 2010;12(2):55-61.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.