PND91 APPLICATION OF BIG DATA IN RARE DISEASE MANAGEMENT: TREATMENT COST OF THERAPEUTIC PLASMA EXCHANGE VERSUS IMMUNOGLOBULINS IN AN INPATIENT SETTING

Abstract

To compare the treatment cost and usage of therapeutic plasma exchange (TPE) and Intravenous Immunoglobulins (IVIg) for the rare diseases Myasthenia Gravis (MG), Guillain-Barré Syndrome (GBS) and Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) in inpatient settings at statistically relevant levels. As rare disease patients are scattered over entire countries and continents, large scale evaluations of treatment costs are perceived as difficult. Hence,we applied a retrospective cohort study design utilizing hospital discharge records. The study included 15,110 patient records from 2013 – 2018 from the USA. Out of 15,110 inpatient admissions GBS accounted for n = 7101 (12.8% TPE; 87.2% IVIg), CIDP n = 2155 (15.4% TPE; 84.6% IVIg), chronic MG: n = 1388 (23.3% TPE; 76.7% IVIg) and acute MG n = 4466 (31.4% TPE; 68.6% IVIg). Most patients were treated with IVIG. However, in each of the evaluated indication, the treatment cost for TPE was significantly (p< 0.01) lower than for IVIg. The following average costs were identified: (1) GBS: TPE: $5,500; IVIg: $14,307, (2) CIDP: TPE: $4,330; IVIg: $12,918, (3) Chronic MG TPE: $3,787 IVIg: $10,961 and (4) Acute MG: TPE: $5,677; IVIg: $13,489. Using large scale data coming from hospitalized patients diagnosed with four selected neuromuscular conditions (GBS, CIDP, MG without and with acute exacerbation), therapy costs with TPE were found to be significantly lower when compared to IVIg therapy costs. Hospitals investing in therapeutic plasma exchange are likely to experience savings in their treatment costs.