Clinical Outcome Measures Poster Presentation

P0054 - Cost of a relapse-free patient in relapsing-remitting multiple sclerosis, a reliable result-based health indicator. (ID 461)

Speakers
  • L. Romero-Pinel
Authors
  • L. Romero-Pinel
  • L. Bau
  • E. Matas
  • I. León
  • R. Juvany
  • R. Jódar
  • A. Martínez-Yélamos
  • S. Martínez-Yélamos
Presentation Number
P0054
Presentation Topic
Clinical Outcome Measures

Abstract

Background

Nowadays we know the efficacy and safety of disease-modifying therapies (DMTs) in multiple sclerosis (MS) but we lack result-based health indicators to evaluate its cost-effectiveness.

Objectives

The objective of the study is to analyze if the cost per year of a relapse-free patient is a reliable health indicator comparing the cost between 2016 and 2019 of DMTs in a cohort of relapsing-remitting MS (RRMS) treated with DMTs in a representative population cohort.

Methods

Patients followed in our MS unit during 2019, diagnosed with MS and belonging to our sanitary district were evaluated, our center has the only MS unit in the district. From them, patients diagnosed with RRMS were retrospectively selected for this study. Clinical data were collected prospectively on a 6-monthly basis and at the time of any relapse. All patients were visited by a qualified neurologist who performed a neurological examination assessing the disease severity by the Expanded Disease Status Scale (EDSS). Data from magnetic resonance imaging (MRI) were retrospectively retrieved. The proportion of patients with no evidence of disease activity (NEDA) was analysed. The mean cost of DMTs during 2019 had been analyzed as well as the cost of a relapse-free patient. The cost of a relapse-free patient was a ratio between the total cost of DMTs and the number of relapse-free patients. The results of 2019 were compared with the results already obtained in 2016.

Results

A total of 214 patients belonging to our sanitary district diagnosed with MS and followed in our MS unit in 2019, were selected. They indicated an MS prevalence of 105 per 100000 inhabitants, representative of the expected prevalence of MS in epidemiological population-based studies performed in our area. From them, 183 patients were RRMS and were included in our study. They were 67.8% women, their mean age was 48.3 (SD 12.9) years, their mean age at onset was 31.8 (SD 10.8) years, their disease duration was 16.32 (SD 11.7) years and their median irreversible EDSS was 2.0 (range 0-7.5). From those 183, 126 patients (68.9% of the cohort) were treated with DMTs during 2019, 151 patients (82.5% of the cohort) remained free of relapses during 2019, 171 patients did not increase their EDSS (93.4% of the cohort) and 126 of the 144 with Magnetic Resonance Imaging (MRI) in 2019 had neither new T2 lesions nor gadolinium-enhancing lesions (87.5%). The proportion of NEDA (no evidence of disease activity) in those 144 patients was 69.4%. The mean cost of DMTs per patient in 2019 was 6985.4 euros (95% CI: 5986.9-7983.9) when all patients were considered, relapse-free and relapsing patients as well as treated and not treated, in 2016 it was 7414.3 euros (95% CI: 6325.2-8503.4). The cost per year of DMTs of a relapse-free patient was 8465.8 euros in 2019 and 9762.2 euros in 2016.

Conclusions

The cost per year of a relapse-free patient may be a reliable result-based health indicator given its stability in successive measurements in the same population.

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