Health Resource Utilization by Disease Stage for People with Amyotrophic Lateral Sclerosis (pALS) in the French National Health Data System (SNDS)
Author(s)
Stenson K1, Hadjrabia H2, Boer F2, Doutriaux A2, Avot D3, Issa S4, Marguet S4, Bernard F4, Nasanbat E4, Nowacki G4, de Pouvourville G5, Corcia P6, Couratier P7
1Biogen, Weymouth, MA, USA, 2Biogen, Paris, France, 3Formerly of Biogen, Paris, France, 4Cerner Enviza, Paris, France, 5ESSEC Business School, Cergy Pontoise, France, 6CRMR SLA, CHU Tours, Tours, France, 7CRMR SLA & autres maladies du neurone moteur CHU de Limoges, Limoges, France
Presentation Documents
OBJECTIVES: The aim of this study was to describe healthcare resource use in pALS, overall and across disease stages in France.
METHODS: A retrospective longitudinal study was conducted among newly diagnosed pALS identified between 2012 and 2019 in the French National Health Data System, SNDS. pALS were identified as having at least 2 events (or 1 event in the case of death) within 6 months: reimbursement of riluzole, and/or diagnosis of motor neuron disease (MND, ICD-10 code G12.2). We excluded people who had at least one diagnosis for Parkinson disease, Multiple sclerosis, and other conditions within G12 (spinal muscular atrophy and related syndromes), 6 months after the first ALS event. A symptom- and milestone-based algorithm was used to define progression stages: early, middle, and late. Staging criteria were selected from the 2-year pre-index date (date diagnosis criteria met) until the end of follow-up. Stage onset was determined by the first occurrence of an event defining that stage. Disease progression to a later stage was irreversible.
RESULTS: We identified 18,289 incident cases, among which 11,215, 15,098 and 16,025 had an early-, middle- and late-stage of ALS. Overall, 97.4% of patients had at least one hospitalization (60.9%, 85.6% and 80.8% among patients with early-, middle- and late-stage respectively), 59.6% had admissions primarily related to ALS (26.3%, 39.0% and 33.0%), 67.5% experienced one-day hospitalizations (30.5%, 49.6% and 44.0%) and 25.6% were admitted in an intensive care unit (2.8%, 7.6% and 21.9%). The rate of all-cause hospitalizations was 1.98 per patient-year (PPY) for the overall population, and 1.46, 1.66, and 2.82 PPY for patients in early-, middle-, and late-stages, respectively.
CONCLUSIONS: These real-world findings demonstrate significant healthcare burden related to the management of ALS across all stages of progression and increasing with advanced disease, highlighting the potential value of delaying progression into a more resource-intensive stage.
Conference/Value in Health Info
Value in Health, Volume 26, Issue 11, S2 (December 2023)
Code
EE657
Topic
Economic Evaluation
Disease
Neurological Disorders, No Additional Disease & Conditions/Specialized Treatment Areas