Burden of Illness and Healthcare Resource Utilization Among Patients Newly Diagnosed With Amyotrophic Lateral Sclerosis in the United States: A Retrospective, Observational, Cohort Design Study
Author(s)
Sophie Guillonneau, MSc1, Ekaterina Smolkina, MSc2, Michelle Baglia, PhD, MPH3, Kalyani Hawaldar, MS3, Bismi Dominic, MCA4.
1Sanofi, Gentilly, France, 2Sanofi, Amsterdam, Netherlands, 3Sanofi, Cambridge, MA, USA, 4Sanofi, Hyderabad, India.
1Sanofi, Gentilly, France, 2Sanofi, Amsterdam, Netherlands, 3Sanofi, Cambridge, MA, USA, 4Sanofi, Hyderabad, India.
OBJECTIVES: To understand the burden of illness, healthcare resource utilisation (HCRU) and healthcare costs (HCCs) among patients with newly diagnosed amyotrophic lateral sclerosis (ALS) in the United States (US).
METHODS: Adult patients newly diagnosed with ALS, who had ≥12 months of baseline health plan enrolment and ≥30 days of follow-up enrolment, were identified using an administrative claims database between 01 January 2017 and 30 June 2022. Patients’ demographics were assessed on index date, comorbidities were assessed over one-year baseline, and HCRU and HCCs were assessed at baseline and over follow-up.
RESULTS: Of the 2,522 patients identified (75.3% aged ≥65 years at diagnosis; 55.2% male), 567 had commercial insurance (49.6% aged 55-64 years; 60.7% male), and 1,954 had Medicare Advantage (91.7% aged ≥65 years; 53.5% male). At baseline, the most common comorbidities were musculoskeletal conditions (89.8% [n=2,265]), nervous system disorders (85.2% [n=2,149]), endocrine disorders (84.4% [n=2,129]), and circulatory diseases (80.8% [n=2,037]). From baseline to follow-up, there was an increase in hospitalisation rates (26.1% to 51.4%), intensive care unit (ICU) admissions (10.5% to 26.6%) and emergency department (ED) visits (42.8% to 48.4%) in the overall population. In contrast, the rate of specialist visits decreased from 97.7% to 90.6% and that of non-ED outpatient visits from 98.2% to 91.4%. Over a mean±standard deviation follow-up of 1.4±1.3 years, the mean total costs (medical services and pharmacy) per patient per month (PPPM) increased from $4,394 at baseline to $14,408 over follow-up; this increase in mean costs PPPM was primarily driven by all-cause hospitalisations ($1,886 to $9,306), ICU admissions ($306 to $2,676), and non-ED outpatient cases ($1,421 to $1,767).
CONCLUSIONS: This study highlights the significant clinical and economic burden of ALS in the US, marked by high comorbidity rates (~≥80%), increased HCRU post-diagnosis, and a ~3-fold increase in monthly HCCs.
METHODS: Adult patients newly diagnosed with ALS, who had ≥12 months of baseline health plan enrolment and ≥30 days of follow-up enrolment, were identified using an administrative claims database between 01 January 2017 and 30 June 2022. Patients’ demographics were assessed on index date, comorbidities were assessed over one-year baseline, and HCRU and HCCs were assessed at baseline and over follow-up.
RESULTS: Of the 2,522 patients identified (75.3% aged ≥65 years at diagnosis; 55.2% male), 567 had commercial insurance (49.6% aged 55-64 years; 60.7% male), and 1,954 had Medicare Advantage (91.7% aged ≥65 years; 53.5% male). At baseline, the most common comorbidities were musculoskeletal conditions (89.8% [n=2,265]), nervous system disorders (85.2% [n=2,149]), endocrine disorders (84.4% [n=2,129]), and circulatory diseases (80.8% [n=2,037]). From baseline to follow-up, there was an increase in hospitalisation rates (26.1% to 51.4%), intensive care unit (ICU) admissions (10.5% to 26.6%) and emergency department (ED) visits (42.8% to 48.4%) in the overall population. In contrast, the rate of specialist visits decreased from 97.7% to 90.6% and that of non-ED outpatient visits from 98.2% to 91.4%. Over a mean±standard deviation follow-up of 1.4±1.3 years, the mean total costs (medical services and pharmacy) per patient per month (PPPM) increased from $4,394 at baseline to $14,408 over follow-up; this increase in mean costs PPPM was primarily driven by all-cause hospitalisations ($1,886 to $9,306), ICU admissions ($306 to $2,676), and non-ED outpatient cases ($1,421 to $1,767).
CONCLUSIONS: This study highlights the significant clinical and economic burden of ALS in the US, marked by high comorbidity rates (~≥80%), increased HCRU post-diagnosis, and a ~3-fold increase in monthly HCCs.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE118
Topic
Economic Evaluation, Epidemiology & Public Health, Study Approaches
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Neurological Disorders, No Additional Disease & Conditions/Specialized Treatment Areas