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Account

Table 2 Costs of MG reported by included studies

From: Economic Costs of Myasthenia Gravis: A Systematic Review

Author (year)

Estimated cost(s)

Perspective of analysis

Currency; year of valuation

Cost result(s) [in 2018 US dollars§]

Risk of bias

Chicaiza-Becerra et al. (2012) [9]

Cost of MG crisis (including medical treatment and inpatient care)

Healthcare/payer

Colombian peso (COL$); 2008

Mean per-patient cost of myasthenic crisis (n = NR): COL$10,360 [< $10]

Selection: ◊◊◊◊

Comparability: ◊ (age and sex NR)

Outcome: ◊◊◊

Desai et al. (2020) [23]

Cost per hospitalization of takotsubo syndrome secondary to MG crisis (i.e. total hospital charge)

Healthcare/payer

US dollar ($); year NRa

Median per-patient cost per hospitalization (n = 175): $134,000 [$142,130]

Selection: ◊◊◊◊

Comparability: ◊◊

Outcome: ◊◊◊

Furlan et al. (2016) [10]

Cost of IVIG and PLEX (including hospital costs, costs of blood products, and physician fees) as treatment for exacerbation of moderate to severe MG

Healthcare/payer

Canadian dollar (C$); 2014

Mean per-patient cost of IVIG (n = 32): C$8310 [$6620]

Mean per-patient cost of PLEX (n = 38): C$6270 [$4990]

Selection: ◊◊◊◊

Comparability: ◊◊

Outcome: ◊◊◊

Guptill et al. (2011) [11]

Direct medical cost

Healthcare/payer

US dollar ($); year NRb

Mean per-patient annual direct medical cost (pooled sample, n = 1288): $24,990 [$28,780]

Mean per-patient annual direct medical cost (age: 0–19 years, n = 21): $7910 [$9100]

Mean per-patient annual direct medical cost (age: 20–39 years, n = 84): $37,520 [$43,210]

Mean per-patient annual direct medical cost (age: 40–65 years, n = 704): $27,610 [$31,790]

Mean per-patient annual direct medical cost (age: > 65 years, n = 479): $20,690 [$23,820]

Selection: ◊◊◊◊

Comparability: ◊◊

Outcome: ◊◊◊

Guptill et al. (2012) [12]

Direct medical cost

Healthcare/payer

US dollar ($); year NRc

Mean per-patient annual direct medical cost (n = 113): $20,190 [$23,630]

Selection: ◊◊◊◊

Comparability: ◊◊

Outcome: ◊◊◊

Heatwole et al. (2011) [13]

Cost of IVIG and PLEX (including cost of therapy, cost of hospitalization, and cost of secondary complications) as a treatment for MG crisis

Healthcare/payer

US dollar ($); year NRb

Mean per-patient cost of IVIG (n = NR): $78,810 [$90,760]

Mean per-patient cost of PLEX (n = NR): $101,140 [$116,470]

Selection: ◊◊◊◊

Comparability: ◊ (age and sex NR)

Outcome: ◊◊◊

Lai and Tseng (2010) [14]

Direct medical cost; cost per outpatient care service; cost per hospitalization

Healthcare/payer

New Taiwan dollar (NT$); 2007

Mean per-patient direct medical cost (n = 3205): NT$42,080 [$1780]

Mean per-patient cost per outpatient care service (n = 3205): NT$1890 [$80]

Mean per-patient cost per hospitalization (n = 3205): NT$107,980 [$4560]

Selection: ◊◊◊◊

Comparability: ◊ (age and sex NR)

Outcome: ◊◊◊

Mandawat et al. (2010) [15]

Hospital cost (i.e. total hospital charge) of IVIG and PLEX as treatment for MG and MG crisis, respectively

Healthcare/payer

US dollar ($); year NRd

Median per-patient hospital cost of IVIG (MG, n = 171): $21,120 [$28,080]

Median per-patient hospital cost of PLEX (MG, n = 737): $26,660 [$35,450]

Median per-patient hospital cost of IVIG (MG crisis, n = 169): $33,920 [$45,100]

Median per-patient hospital cost of PLEX (MG crisis, n = 529): $53,800 [$71,520]

Selection: ◊◊◊◊

Comparability: ◊◊

Outcome: ◊◊◊

Mouri et al. (2019) [16]

Cost per hospitalization (i.e. total hospital charge)

Healthcare/payer

US dollar ($); year NRe

Median per-patient cost per hospitalization (sugammadex, n = 506): $13,190 [$13,800]

Median per-patient cost per hospitalization (placebo, n = 289): $14,120 [$14,770]

Selection: ◊◊◊◊

Comparability: ◊◊

Outcome: ◊◊◊

Narla et al. (2020) [24]

Cost per hospitalization (derived from hospital charges using the cost-to-charge ratio from the HCUP)

Healthcare/payer

US dollar ($); 2014

Mean (geometric) per-patient cost per hospitalization (pemphigus, n = NR): $14,970 [$15,880]

Mean (geometric) per-patient cost per hospitalization (pemphigoid, n = NR): $13,300 [$14,110]

Selection: ◊◊◊◊

Comparability: ◊ (age and sex NR)

Outcome: ◊◊◊

Ogino et al. (2017) [17]

Direct medical cost

Healthcare/payer

Yen (¥); 2016

Mean per-patient annual direct medical cost (n = NR): ¥82,940 [$760]

Selection: ◊◊◊◊

Comparability: ◊ (age and sex NR)

Outcome: ◊◊◊

Omorodion et al. (2017) [18]

Cost per hospitalization (i.e. total hospital charge)

Healthcare/payer

US dollar ($); 2013

Mean per-patient cost per hospitalization (pooled sample, n = 5535): $98,800 [$106,490]

Mean per-patient cost per hospitalization (age: 1–7 years, n = 145): $66,860 [$72,070]

Mean per-patient cost per hospitalization (age: 18–44 years, n = 1195): $82,790 [$89,240]

Mean per-patient cost per hospitalization (age: 45–64 years, n = 1705): $93,030 [$100,280]

Mean per-patient cost per hospitalization (age: 65–84 years, n = 2165): $117,000 [$126,110]

Mean per-patient cost per hospitalization (age: ≥ 85 years, n = 320): $83,710 [$90,240]

Mean per-patient cost per hospitalization (males, n = 2380): $110,490 [$119,100]

Mean per-patient cost per hospitalization (females, n = 3150): $90,290 [$97,330]

Selection: ◊◊◊◊

Comparability: ◊◊

Outcome: ◊◊◊

Schepelmann et al. (2010) [19]

Direct medical cost; indirect cost (production losses due to absenteeism and presenteeism, as well as informal care, estimated using the HCA); and total cost of illness

Societal

Euro (€); 2009

Mean per-patient annual direct medical cost (n = 41): €11,840 [$15,050]

Mean per-patient annual indirect cost (including informal care) (n = 41): €2790 [$3550]

Mean per-patient annual informal care cost (n = 41): €910 [$1160]

Mean per-patient annual total cost of illness (n = 41): €14,950 [$19,000]

Mean per-patient annual total cost of illness (ADL assistance, n = NR): €44,690 [$56,800]

Mean per-patient annual total cost of illness (no ADL assistance, n = NR): €11,360 [$14,440]

Selection: ◊◊◊◊

Comparability: ◊◊

Outcome: ◊◊ (self-reported data)

Sonkar et al. (2017) [20]

Direct medical cost (i.e. out-of-pocket expenditures incurred

during the management of MG and associated co-morbiditiesf); indirect cost (i.e. production losses due to absenteeism and presenteeism) estimated using the HCAg

Societal

Indian rupee (₹); 2016

Median per-patient annual direct medical cost (n = 66): ₹48,570 [$730]

Median per-patient annual indirect cost (n = 66): ₹5100 [$80]

Median per-patient annual total cost of illness (n = 66): ₹61,390 [$920]

Selection: ◊◊◊◊

Comparability: ◊◊

Outcome: ◊◊ (self-reported data)

Souayah et al. (2009) [21]

Cost per hospitalization (i.e. total hospital charge)

Healthcare/payer

US dollar ($); 2002

Mean per-patient cost per hospitalization (pooled sample, n = 994): $118,000 [$164,730]

Mean per-patient cost per hospitalization (age: < 50 years, n = 196): $113,100 [$157,890]

Mean per-patient cost per hospitalization (age: ≥ 50 years, n = 798): $119,100 [$166,260]

Mean per-patient cost per hospitalization (urban teaching hospital, n = NR): $75,200 [$104,980]

Mean per-patient cost per hospitalization (urban non-teaching hospital, n = NR): $118,300 [$165,150]

Selection: ◊◊◊◊

Comparability: ◊◊

Outcome: ◊◊◊

Tiamkao et al. (2014) [22]

Cost per hospitalization (i.e. total hospital charge)

Healthcare/payer

Thai baht (฿); 2010

Mean per-patient cost per hospitalization (n = 936): ฿68,730 [$2550]

Selection: ◊◊◊◊

Comparability: ◊◊

Outcome: ◊◊◊

  1. Costs were rounded to the nearest ten
  2. Details of resources included in estimates of direct medical costs are presented in Table 3
  3. ADL activities of daily living, HCA human capital approach, HCUP Healthcare Cost and Utilization Project, IVIG intravenous immunoglobulin, MG myasthenia gravis, NR not reported, PLEX plasma exchange
  4. §Converted to United States (US) dollars ($) [Colombian peso COL$1 = $0.00030; Canadian dollar C$1 = $0.747; New Taiwan dollar NT$1 = $0.032; Yen ¥1 = $0.009; Euro (German) €1 = $1.130; Indian rupee ₹1 = $0.014; and Thai baht ฿1 = $0.033] and inflated to 2018 values using consumer price index data from the World Bank [7]
  5. Assessed with the Newcastle–Ottawa Scale. Maximum score: ◊◊◊◊ for selection, ◊◊ for comparability, and ◊◊◊ for outcome (see “Methods” section for details)
  6. aIn the absence of data, year of valuation was assumed to be 2014
  7. bIn the absence of data, year of valuation was assumed to be 2010
  8. cIn the absence of data, year of valuation was assumed to be 2009
  9. dIn the absence of data, year of valuation was assumed to be 2005
  10. eIn the absence of data, year of valuation was assumed to be 2016
  11. fIncluding costs of transportation to the hospital, subsequent hospitalization, over-the-counter medications, laboratory tests, and the food consumed during the waiting period
  12. g Indirect cost of illness also included time lost for the patient and caregivers (valued at the daily wage), as well as caregivers’ expenditure for travel, food, and stay while in hospital