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COST



Cost Comparison


A 2017 literature review found that TPE was more cost-efficient than IVIg in 11 of 15 publications and costs were on average 53% lower.1

  • 11 out of 15 publications found TPE was more cost-efficient than IVIg.
  • 3 were undecided.
  • 1 reported IVIg was more cost-efficient than TPE.
  • Expected health outcomes were identical. Depending on the publication, potential savings varied largely. The weighted average savings was based on all 15 publications.




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Cost Analysis: IVIg Versus Plasma Exchange

A 2017 cost analysis from the University of California San Diego showed:

A COURSE OF 5 STANDARD INFUSIONS OF IVIg WAS MORE THAN TWICE AS EXPENSIVE AS 5 PLASMA EXCHANGE TREATMENTS

Analysis included central venous access placement, amortization of the plasma exchange device, apheresis nurse time and supplies.












Apheresis-Related Safety Information

Contraindications

Leukocytapheresis is contraindicated in acute myeloid leukemia FAB M3 (acute promyelocytic leukemia) because of the accompanying disseminated intravascular coagulation.1,2 Other contraindications for the use of the Spectra Optia system are limited to those associated with the infusion of solutions and replacement fluids as required by the apheresis procedure and those associated with all types of automated apheresis systems.

Adverse events of apheresis procedures can include

Anxiety, headache, light-headedness, digital and/or facial paresthesia, fever, chills, hematoma, hyperventilation, nausea and vomiting, syncope (fainting), urticaria, hypotension, allergic reactions, infection, hemolysis, thrombosis in patient and device, hypocalcemia, hypokalemia, thrombocytopenia, hypoalbuminemia, anemia, coagulopathy, fatigue, hypomagnesemia, hypogammaglobulinemia, adverse tissue reaction, device failure/disposable set failure, air embolism, blood loss/anemia, electrical shock, fluid imbalance and inadequate separation of blood components.

Reactions to blood products transfused during procedures can include

Hemolytic transfusion reaction, immune-mediated platelet destruction, fever, allergic reactions, anaphylaxis, transfusion-related acute lung injury (TRALI), alloimmunization, posttransfusion purpura (PTP), transfusion-associated graft-versus-host disease (TA-GVHD), circulatory overload, hypothermia, metabolic complications and transmission of infectious diseases and bacteria.3,4

Restricted to prescription use only

  • Operators must be familiar with the system's operating instructions
  • Procedures must be performed by qualified medical personnel.

1Vahdat L, Maslak P, Miller WH Jr, et al. Early mortality and the retinoic acid syndrome in acute promyelocytic leukemia: impact of leukocytosis, low-dose chemotherapy, PMN/RAR-alpha isoform and CD13 expression in patients treated with all-trans retinoic acid. Blood. 1994;84(11):3843-3849.

2Daver N, Kantarjian H, Marcucci G, et al. Clinical characteristics and outcomes in patients with acute promyelotic leukaemia and hyperleucocytosis. Br J Haematol. 2015;168(5):646-653.

3AABB. Circular of Information for the Use of Human Blood and Blood Components. Bethesda, MD: AABB; 2017.

4European Directorate for the Quality of Medicines & HealthCare (EDQM). Guide to the Preparation, Use and Quality Assurance of Blood Components. 19th edition. Strasbourg, France: EDQM Council of Europe; 2017.



1Dierick K, Khalife N. Literature Review conducted by Terumo BCT Health Economics and Outcomes Research (HEOR). An overview on the cost efficiency of therapeutic plasma exchange in treating Guillain-Barré syndrome. 2017.The ISPOR Scientific Presentations Database.






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