CLINICAL AND ECONOMIC BURDEN OF GENERALIZED MYASTHENIA GRAVIS IN THE BRAZILIAN SUPPLEMENTARY HEALTHCARE SYSTEM: A REAL-WORLD STUDY (2019-2025)
Author(s)
Joao Paulo Dos Reis Neto, PhD, MD1, JULIANA BUSCH, MD2.
1ceo, Diretor-Presidente da Capesesp, Rio de Janeiro, Brazil, 2CAPESESP, Rio de Janeiro, Brazil.
1ceo, Diretor-Presidente da Capesesp, Rio de Janeiro, Brazil, 2CAPESESP, Rio de Janeiro, Brazil.
OBJECTIVES: To evaluate the clinical, healthcare resource utilization (HCRU), and economic burden of generalized myasthenia gravis (gMG) among beneficiaries of a healthcare management organization (HMO) between 2019 and 2025.
METHODS: Retrospective analysis using administrative data (Jan/2019 to Dec/2025) to evaluate beneficiaries with at least one ICD-10 G70 diagnosis code. Demographic characteristics, HCRU including outpatient visits, diagnostic tests, therapies, emergency department visits, hospitalizations, length of stay (LOS), direct medical costs, and overall survival were assessed. Costs were stratified by care setting and expenditure category. Overall survival was estimated using Kaplan-Meier analysis. Statistical significance: p<0.05.
RESULTS: The observed prevalence of myasthenia gravis was 33 cases per 100,000 beneficiaries. Most patients were female (67%), with a mean age of 70 years. Mean annual HCRU per patient included 7.3 outpatient visits, 82.4 diagnostic tests, 85.8 therapies, 2.4 emergency visits, and 1.4 hospitalizations. LOS was 16.7 days. Hospital-related expenditures accounted for approximately 81% of total direct healthcare costs, mainly driven by medications (44%), hospital daily rates (25%), and materials/medical devices (23%). A marked concentration of expenditure was observed in a small subgroup of high-complexity patients, with 17% presenting annual costs above BRL 300,000 (US$ 60,000). Five-year overall survival was 56%.
CONCLUSIONS: Although rare, gMG imposes substantial clinical and economic burden on the Brazilian private healthcare system, particularly through recurrent hospitalizations, prolonged LOS and high-cost therapies. The marked concentration of costs in severe and high-complexity patients highlights the need for structured care pathways, earlier diagnosis, and longitudinal care coordination. Emerging targeted immunotherapies, including FcRn antagonists and complement inhibitors, may significantly modify the disease trajectory by reducing pathogenic autoantibodies, exacerbations, rescue therapies, and hospitalization rates. In the private healthcare setting, these therapies may represent not only a clinical advance, but also a potential strategy to reduce long-term HCRU and improve outcomes in patients with gMG.
METHODS: Retrospective analysis using administrative data (Jan/2019 to Dec/2025) to evaluate beneficiaries with at least one ICD-10 G70 diagnosis code. Demographic characteristics, HCRU including outpatient visits, diagnostic tests, therapies, emergency department visits, hospitalizations, length of stay (LOS), direct medical costs, and overall survival were assessed. Costs were stratified by care setting and expenditure category. Overall survival was estimated using Kaplan-Meier analysis. Statistical significance: p<0.05.
RESULTS: The observed prevalence of myasthenia gravis was 33 cases per 100,000 beneficiaries. Most patients were female (67%), with a mean age of 70 years. Mean annual HCRU per patient included 7.3 outpatient visits, 82.4 diagnostic tests, 85.8 therapies, 2.4 emergency visits, and 1.4 hospitalizations. LOS was 16.7 days. Hospital-related expenditures accounted for approximately 81% of total direct healthcare costs, mainly driven by medications (44%), hospital daily rates (25%), and materials/medical devices (23%). A marked concentration of expenditure was observed in a small subgroup of high-complexity patients, with 17% presenting annual costs above BRL 300,000 (US$ 60,000). Five-year overall survival was 56%.
CONCLUSIONS: Although rare, gMG imposes substantial clinical and economic burden on the Brazilian private healthcare system, particularly through recurrent hospitalizations, prolonged LOS and high-cost therapies. The marked concentration of costs in severe and high-complexity patients highlights the need for structured care pathways, earlier diagnosis, and longitudinal care coordination. Emerging targeted immunotherapies, including FcRn antagonists and complement inhibitors, may significantly modify the disease trajectory by reducing pathogenic autoantibodies, exacerbations, rescue therapies, and hospitalization rates. In the private healthcare setting, these therapies may represent not only a clinical advance, but also a potential strategy to reduce long-term HCRU and improve outcomes in patients with gMG.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
RWD104
Topic
Health Service Delivery & Process of Care, Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
Neurological Disorders, Rare & Orphan Diseases