Neuromyelitis Optica and Anti-MOG Disease Poster Presentation

P0705 - Cost of illness for patients with NMOSD and nonautoimmune disease estimated from claims databases in the United States   (ID 1054)

Speakers
  • A. Exuzides
Authors
  • A. Exuzides
  • D. Sheinson
  • P. Sidiropoulos
  • S. Gholizadeh
  • F. Magrini
  • A. Surinach
  • L. Cook
  • C. Meyer
  • M. Yeaman
Presentation Number
P0705
Presentation Topic
Neuromyelitis Optica and Anti-MOG Disease

Abstract

Background

Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune disease of the central nervous system that often results in substantial neurological deficits and disability. NMOSD has been associated with various comorbidities, including autoimmune conditions, cardiovascular disease (CD) and type II diabetes (DMII). In this analysis, real-world healthcare utilization and cost of illness were analyzed in patients with NMOSD and concomitant nonautoimmune morbidities (CnAIDs).

Objectives

To evaluate the cost of illness in patients with NMOSD and CnAID compared with controls without NMOSD (non-NMOSD) or NMOSD without CnAID in US commercial claims databases.

Methods

This study used claims from the Truven Health MarketScan Commercial and Medicare Supplemental Databases between 2014 and 2018. Patients were identified as having NMOSD if they had ≥1 inpatient or ≥2 outpatient claims for NMOSD diagnosis ≥60 days apart or ≥2 claims for transverse myelitis diagnosis in combination with ≥1 claim for optic neuritis ≥6 months apart. Continuous enrollment ≥6 months before and ≥1 year after the first claim (index date) was required. Non-NMOSD controls were matched 5:1 to patients with NMOSD. Total costs stratified by CnAID in consumer price index–adjusted 2019 US dollars within 12 months post–index date were calculated for each patient.

Results

In the NMOSD group, 100/162 patients (61.7%) had ≥1 CnAIDs vs 328/810 (40.5%) matched non-NMOSD controls, with 60/162 (37.0%) in the NMOSD group having multiple CnAIDs vs 177/810 (21.9%) in matched non-NMOSD controls. These included CD (27.2% vs 10.1%; p<0.001), DMII (15.4% vs 8.6%; p=0.013), hyperglycemia (HG; 7.4% vs 3.2%; p=0.023) or liver disease (LD, excludes infection; 6.8% vs 2.4%; p=0.009). Total median [IQR] healthcare costs per patient during the postindex follow-up period were significantly higher for patients with NMOSD and CnAID ($36,618 [$13,503–$116,645]) vs matched non-NMOSD controls with CnAID ($4,960 [$1,709–$13,654]; p<0.001) or NMOSD without CnAID ($21,644 [$6,339–$55,061]; p=0.041).

Conclusions

Patients with NMOSD and CnAID incurred significantly higher costs associated with healthcare resource utilization compared with non-NMOSD matched controls or patients with NMOSD but without CnAID. These results demonstrate the higher CnAID prevalence and subsequent cost burden associated with CnAID (primarily CD, DMII, HG and LD) in patients with NMOSD and therefore the need to identify more cost-efficient, integrated therapeutic approaches to address the overlap of NMOSD and comorbidities.

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