Phillips Glenn, Abreu Catarina, Goyal Amit, Li Yuebing, Whangbo Albert, Gelinas Deborah, Brauer Edward, Bhattacharya Sankha
argenx US Inc., Boston, MA, United States.
ZS Associates, New York, NY, United States.
Front Neurol. 2022 Jan 18;12:809999. doi: 10.3389/fneur.2021.809999. eCollection 2021.
Limited evidence exists for healthcare resource utilization (HCRU) and costs associated with generalized myasthenia gravis (gMG), a rare autoimmune disorder, for adults in the United States.
Adults with ≥1 diagnostic claim for MG between 2014 and 2019 were identified using Symphony Health's Integrated Dataverse®. Using a novel algorithm, HCRU and costs over 12 months following index dates were evaluated for patients with gMG including those with exacerbation events. For patients who experienced crisis events, HCRU and costs were analyzed during the 36 months preceding, during, and 12 months following the events.
Mean HCRU and costs were higher for newly diagnosed patients compared with previously diagnosed patients (hospitalizations: 0.46 vs. 0.34; all-cause costs: $26,419.20 vs. $24,941.47; direct costs for gMG treatments: $9,890.37 vs. $9,186.47) and further increased for patients with exacerbation events (hospitalizations: 0.72; all-cause costs: $43,734.15; direct costs for gMG treatments: $21,550.02). For patients who experienced crisis events, HCRU and costs markedly increased during the 12 months immediately before the crisis event (hospitalizations: 1.35; all-cause costs: $49,236.68) compared with the 2 preceding years and increased further during the 12 months following the crisis index date (hospitalizations: 2.78; all-cause costs: $173,956.99). Cost increases were, in large part, attributed to treatments received.
New diagnosis, exacerbation, and crisis events were drivers of HCRU and cost for patients with gMG. Particularly, high costs of gMG-specific medications associated with intervention for exacerbation and crisis events contributed to increased all-cause costs.
在美国,关于医疗资源利用(HCRU)以及与罕见自身免疫性疾病——全身型重症肌无力(gMG)相关的成本,现有证据有限。
使用Symphony Health的综合数据集®识别2014年至2019年间有≥1次MG诊断索赔的成年人。采用一种新颖的算法,对gMG患者(包括那些有病情加重事件的患者)在索引日期后的12个月内的HCRU和成本进行评估。对于经历危机事件的患者,分析事件发生前36个月、事件期间以及事件发生后12个月的HCRU和成本。
与先前诊断的患者相比,新诊断患者的平均HCRU和成本更高(住院次数:0.46对0.34;全因成本:26,419.20美元对24,941.47美元;gMG治疗的直接成本:9,890.37美元对9,186.47美元),病情加重事件患者的HCRU和成本进一步增加(住院次数:0.72;全因成本:43,734.15美元;gMG治疗的直接成本:21,550.02美元)。对于经历危机事件的患者,与危机事件前2年相比,危机事件前12个月的HCRU和成本显著增加(住院次数:1.35;全因成本:49,236.68美元),并在危机索引日期后的12个月内进一步增加(住院次数:2.78;全因成本:173,956.99美元)。成本增加在很大程度上归因于所接受的治疗。
新诊断、病情加重和危机事件是gMG患者HCRU和成本的驱动因素。特别是,与病情加重和危机事件干预相关的gMG特异性药物的高成本导致了全因成本的增加。