Trends in the Economic Burden of Public Hospital Acute Admissions for Multiple Sclerosis and Cerebellar Ataxia in Australia (2012-2021): An Analysis of Costs and Cost Buckets

OBJECTIVES: Multiple sclerosis (MS) is a central nervous system disease causing progressive disability, often accompanied by cerebellar ataxia (CA) affecting about 37% of MS patients. This study is first to comprehensively investigate longitudinal trends in public hospital acute admissions (PHAAs) and associated costs for MS&CA in Australia.

METHODS: Data from the National Hospital Cost Data Collection in Australia spanning 2012-2021 provided the annual estimates of public hospital activity, including number of separations, average length of stay (ALOS), and costs based on Australian refined Diagnosis Related Groups (DRG) codes overall and by hospital cost bucket. Two DRGs pertaining to MS&CA (B68A: major complexity, B68B: minor complexity) were combined to calculate the burden for all MS&CA. Growth rates (GRs) and compound annual growth rates (CAGRs) were determined for each metric, overall and by complexity.

RESULTS: Total number of MS&CA-related PHAAs in 2021 was 26,491, 77% increase since 2012, with ALOS decreasing by 16% (from 1.5 days to 1.3 days) during the same period. MS&CA-related total PHAA costs sat at $99.0 million in 2021 (GR of 176% since 2012; CAGR:14%). Costs growth rates significantly differed among various cost buckets, with Pharmacy ($62.3m [GR:265%; CAGR:18%]), Ward-nursing ($8.3m [GR:70%; CAGR:7%]) and Ward-medical ($6.5m [GR:144%; CAGR:12%]) being the top three PHHA cost components. Costs growth rates also differed between major and minor complexities. For instance, total PHAA costs-major ($18.9m) and minor ($80.1m) exhibited a GR/CAGR of 137%/11% and 187%/14%, respectively. Whereas, pharmacy-major ($2.9m) and minor ($59.4m) recorded a GR/CAGR of 716%/30% and 255%/17%, respectively.

CONCLUSIONS: The burden of MS&CA-related PHAAs escalated in Australia over time, due to increase in both the numbers and costs of PHAAs. However, disparities in the proportions and growth rates of disease complexity and cost components exist. Understanding this burden and factors affecting it over time is crucial for healthcare decision making in such important domain.