ECONOMIC IMPACT OF ORAL CORTICOSTEROID-RELATED COMORBIDITIES IN PATIENTS WITH ACETYLCHOLINE RECEPTOR ANTIBODY-POSITIVE (ACHR-AB+) GENERALISED MYASTHENIA GRAVIS (GMG) IN THE UNITED STATES (US)
Author(s)
Christopher Scheiner, MD, PhD1, Nicholas Streicher, MD, MPH2, Karen S. Yee, PhD3, Jeffrey C. Yu, PhD, MHS3, Justin Lee, PhD3, Lauren Powell, MPH4, Megan M Gardner, MPH4.
1University of Tennessee Medical Center, Knoxville, TN, USA, 2Georgetown University, Washington, DC, USA, 3Alexion, AstraZeneca Rare Disease, Boston, MA, USA, 4BroadStreet Health Economics & Outcomes Research, Vancouver, BC, Canada.
1University of Tennessee Medical Center, Knoxville, TN, USA, 2Georgetown University, Washington, DC, USA, 3Alexion, AstraZeneca Rare Disease, Boston, MA, USA, 4BroadStreet Health Economics & Outcomes Research, Vancouver, BC, Canada.
OBJECTIVES: Oral corticosteroids (OCS) are commonly used to treat gMG but are associated with substantial systemic adverse effects. This analysis aimed to estimate the annual direct costs of OCS-related comorbidities in patients with AChR-Ab+ gMG receiving OCS >1825 mg/year and determine potential reductions in economic burden by reducing OCS use.
METHODS: Annual costs of OCS-related comorbidities in the US were calculated using an estimated prevalence of AChR-Ab+ gMG receiving OCS >1825 mg/year (prednisone equivalent). Excess cumulative incidence of OCS-related comorbidities was estimated using matched retrospective claims analyses of Komodo Health® database by comparing patients with OCS exposure >1825 mg/year with those not using OCS. Comorbidities included gastrointestinal (GI) disorders, type 2 diabetes (T2D), cardiovascular disease (CVD), osteoporosis or fracture, hypertension, obesity, cataracts or glaucoma, and mood disorders. Literature-based annual per-patient excess healthcare costs were applied to estimate total annual excess costs by comorbidity. Costs were converted and inflated to 2025 USD values.
RESULTS: The excess cumulative incidence attributed to OCS exposure >1825 mg/year was 6.9% for GI disorders, 5.8% for T2D, 4.6% for CVD, 4.3% for osteoporosis/fracture, 3.1% for hypertension, 2.5% for obesity, 1.7% for cataracts/glaucoma, and 1.7% for mood disorders. Among the estimated 49,412 patients with AChR-Ab+ gMG receiving OCS >1825 mg/year in the US, the total excess estimated annual cost attributable to OCS use was $81,062,734 for GI disorders, $37,541,187 for T2D, $28,731,391 for CVD, $19,060,532 for osteoporosis/fracture, $3,907,490 for hypertension, $1,700,098 for obesity, $1,987,476 for cataracts/glaucoma, and $2,678,409 for mood disorders. The combined estimated annual cost for all OCS-related comorbidities was $176,669,317.
CONCLUSIONS: OCS doses >1825 mg/year in patients with AChR-Ab+ gMG are associated with high annual costs of OCS-related comorbidities, which can potentially be avoided with steroid-sparing strategies, reducing economic burden for patients with AChR-Ab+ gMG.
METHODS: Annual costs of OCS-related comorbidities in the US were calculated using an estimated prevalence of AChR-Ab+ gMG receiving OCS >1825 mg/year (prednisone equivalent). Excess cumulative incidence of OCS-related comorbidities was estimated using matched retrospective claims analyses of Komodo Health® database by comparing patients with OCS exposure >1825 mg/year with those not using OCS. Comorbidities included gastrointestinal (GI) disorders, type 2 diabetes (T2D), cardiovascular disease (CVD), osteoporosis or fracture, hypertension, obesity, cataracts or glaucoma, and mood disorders. Literature-based annual per-patient excess healthcare costs were applied to estimate total annual excess costs by comorbidity. Costs were converted and inflated to 2025 USD values.
RESULTS: The excess cumulative incidence attributed to OCS exposure >1825 mg/year was 6.9% for GI disorders, 5.8% for T2D, 4.6% for CVD, 4.3% for osteoporosis/fracture, 3.1% for hypertension, 2.5% for obesity, 1.7% for cataracts/glaucoma, and 1.7% for mood disorders. Among the estimated 49,412 patients with AChR-Ab+ gMG receiving OCS >1825 mg/year in the US, the total excess estimated annual cost attributable to OCS use was $81,062,734 for GI disorders, $37,541,187 for T2D, $28,731,391 for CVD, $19,060,532 for osteoporosis/fracture, $3,907,490 for hypertension, $1,700,098 for obesity, $1,987,476 for cataracts/glaucoma, and $2,678,409 for mood disorders. The combined estimated annual cost for all OCS-related comorbidities was $176,669,317.
CONCLUSIONS: OCS doses >1825 mg/year in patients with AChR-Ab+ gMG are associated with high annual costs of OCS-related comorbidities, which can potentially be avoided with steroid-sparing strategies, reducing economic burden for patients with AChR-Ab+ gMG.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE106
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Neurological Disorders, Rare & Orphan Diseases, Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)