ACUTE AND CHRONIC COSTS OF NEUROMYELITIS OPTICA SPECTRUM DISORDER (NMOSD) MANAGEMENT: ALL-CAUSE AND RELAPSE-RELATED CHARGE DATA IN A SINGLE CENTER
Author(s)
Parker TH1, Kadish R2, Tanvir I3, Royston M3, Kielhorn A4, Clardy S2, Biskupiak JE5
1University of Utah, Pharmacotherapy Outcomes Research Center, Salt Lake City, UT, USA, 2University of Utah, Department of Neurology, Salt Lake City, UT, USA, 3Alexion Pharmaceuticals, Boston, MA, USA, 4Alexion Pharmaceuticals, Norwell, MA, USA, 5University of Utah, Salt Lake City, UT, USA
OBJECTIVES: NMOSD is a relapsing, autoimmune, inflammatory central nervous system disorder characterized by unpredictable attacks of the optic nerves and spinal cord. Observational studies evaluating the healthcare utilization and financial impact of NMOSD are lacking. We present financial charge data from all patients with this disorder to provide all-cause and relapse-related economic outcomes of NMOSD from a specialized academic center. METHODS: We retrospectively studied 171 patients within the University of Utah Health System with an ICD-10 diagnostic code of NMO ever listed in 2006–2019. Cases were independently reviewed by two neuroimmunologists, who confirmed they met Wingerchuk 2015 NMOSD criteria (neuroimmunologist review confirmed 73 cases met these criteria). Available charge data were compiled for these cases to assess all-cause and relapse-related financial impacts. Index date was the date of confirmation of NMOSD diagnosis. RESULTS: Our cohort featured 73 patients with a total follow-up of 79,606 days or 218 person-years, adjusted for any patient with a gap of care of >3 years. Total charges per person-year were $93,738, most of which (59%) came from inpatient stays. Neurology department accounted for >70% of inpatient charges, whereas infusion costs accounted for >65% of outpatient charges. The first 4 years were the most expensive, with >$17 million in total charges, or about $4,850/patient/month. There were 30 relapses resulting in hospitalization that occurred at or post-index with >$7.8 million in total charges. Mean and median total charges per inpatient relapse were $258,932 (SD $331,809) and $123,790 (IQR $77,647–173,632), respectively. Mean and median lengths of stay were 11.9 (SD 8.6) days and 10.5 (IQR 6.3–14.0) days, respectively. CONCLUSIONS: NMOSD is a complex neurological disorder with a significant medical and financial burden, and is related with high all-cause medical charges, particularly due to inpatient admissions. Patients experiencing relapses resulting in a hospitalization incur substantial charges.
Conference/Value in Health Info
2020-05, ISPOR 2020, Orlando, FL, USA
Value in Health, Volume 23, Issue 5, S1 (May 2020)
Code
PND32
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Real World Data & Information Systems
Topic Subcategory
Disease Management, Health & Insurance Records Systems
Disease
Neurological Disorders