Direct Healthcare Costs (HCCs) Inequalities Associated With Myasthenia Gravis (MG) in Hungary: Claims Database Analysis
Author(s)
Bence Nagy, BSc, MASc, MD1, József Jeskó, University, Msc2, Csilla Rozsa, University, Medical Doctor3, Zille Poliaková, MSc, MD4.
1Chief Client Officer, Healthware Tanácsadó Kft, Budapest, Hungary, 2Healthware Consulting Ltd., Budapest, Hungary, 3Department of Neurology, Jahn Ferenc Dél-pesti Hospital Budapest, Department of Neurology, Budapest, Hungary, Budapest, Hungary, 4UCB s.r.o., organizacná zložka, Bratislava, Slovakia.
1Chief Client Officer, Healthware Tanácsadó Kft, Budapest, Hungary, 2Healthware Consulting Ltd., Budapest, Hungary, 3Department of Neurology, Jahn Ferenc Dél-pesti Hospital Budapest, Department of Neurology, Budapest, Hungary, Budapest, Hungary, 4UCB s.r.o., organizacná zložka, Bratislava, Slovakia.
OBJECTIVES: Last year, our research was awarded by ISPOR and presented the first epidemiology and healthcare resource use (HRU) related to the care of MG in Hungary. This research aims to describe the high concentration of HRUs and costs associated with this therapy, and the potential factors behind it.
METHODS: This research consisted of a non-interventional, retrospective analysis of the anonymized health insurance claims database. The research period has been extended by two years, covering from 2018 to 2024. To ensure consistency of the data, the same inclusion and exclusion criteria were used. The analysis was focused on a cohort of patients who were in the top quintile of HCCs. Inequality in the distribution of HCCs and HRUs was determined using Gini coefficient. The Charlson comorbidity index (CCI) and standardised age were examined as explanatory variables.
RESULTS: Based on the descriptive analysis, the male-to-female ratio for men over 70 is 1:1.4. After standardization, this value adjusts to 1:0.58, which aligns with internationally observed ratios. HCCs reveal significant disparities in healthcare expenditure among patients. Only two percent of patients generate one fifth of the HCCs associated with MG. The proportion of treatments involving hospital mechanical ventilation (100%), IVIG (86,2%) and PLEX (69,4%) is high. The distribution of costs within the MG population yields a Gini coefficient of 0.58, indicating exceptionally high inequality. The median age of the lowest quintile (67 years) and the median CCI score (0.71) are both significantly higher than those of the highest quintile (54 years and 0.42, respectively). Furthermore, this trend is reflected consistently across all quintiles.
CONCLUSIONS: The MG patient population exhibits significant cost inequality. Initial results show that higher-cost patient groups tend to be younger with fewer comorbidities. Conversely, as annual care costs decrease, patients tend to be older with more comorbidities.
METHODS: This research consisted of a non-interventional, retrospective analysis of the anonymized health insurance claims database. The research period has been extended by two years, covering from 2018 to 2024. To ensure consistency of the data, the same inclusion and exclusion criteria were used. The analysis was focused on a cohort of patients who were in the top quintile of HCCs. Inequality in the distribution of HCCs and HRUs was determined using Gini coefficient. The Charlson comorbidity index (CCI) and standardised age were examined as explanatory variables.
RESULTS: Based on the descriptive analysis, the male-to-female ratio for men over 70 is 1:1.4. After standardization, this value adjusts to 1:0.58, which aligns with internationally observed ratios. HCCs reveal significant disparities in healthcare expenditure among patients. Only two percent of patients generate one fifth of the HCCs associated with MG. The proportion of treatments involving hospital mechanical ventilation (100%), IVIG (86,2%) and PLEX (69,4%) is high. The distribution of costs within the MG population yields a Gini coefficient of 0.58, indicating exceptionally high inequality. The median age of the lowest quintile (67 years) and the median CCI score (0.71) are both significantly higher than those of the highest quintile (54 years and 0.42, respectively). Furthermore, this trend is reflected consistently across all quintiles.
CONCLUSIONS: The MG patient population exhibits significant cost inequality. Initial results show that higher-cost patient groups tend to be younger with fewer comorbidities. Conversely, as annual care costs decrease, patients tend to be older with more comorbidities.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
SA34
Topic
Epidemiology & Public Health, Real World Data & Information Systems, Study Approaches
Disease
Neurological Disorders, No Additional Disease & Conditions/Specialized Treatment Areas