Policy Analysis Inc. (PAI)

Author Of 2 Presentations

Neuromyelitis Optica and Anti-MOG Disease Poster Presentation

P0706 - Cost of neuromyelitis optica spectrum disorder in US clinical practice (ID 797)

Speakers
Presentation Number
P0706
Presentation Topic
Neuromyelitis Optica and Anti-MOG Disease

Abstract

Background

Neuromyelitis optica spectrum disorder (NMOSD) is a rare, autoimmune condition characterized by unpredictable relapses affecting the optic nerves and spinal cord that can lead to blindness, paralysis, and premature death. Currently, evidence on the real-world economic cost of NMOSD is limited.

Objectives

A retrospective observational matched-cohort analysis was conducted to characterize annual healthcare utilization and expenditure attributed to NMOSD in US clinical practice.

Methods

Data from the IQVIA PharMetrics Plus Healthcare Claims Database were used to identify adults who had evidence of NMOSD (≥1 inpatient diagnosis or ≥2 outpatient diagnoses) between 2013 and 2018 and a comparator group of patients without NMOSD who were matched on age, sex, geographic region, and insurance type. All-cause healthcare utilization and expenditure (2018 US dollars) were calculated for the matched cohorts and annualized to adjust for differential follow-up periods (maximum 6 years), with 95% confidence intervals (CI) calculated via nonparametric bootstrapping. Outcomes were analyzed overall and by care setting, diagnosis, and drug therapy.

Results

The study population included 1,363 patients with NMOSD who were matched 1:1 with comparator patients. The mean age was 45 years (standard deviation: 13 years), and 75% were female. Mean (95% CI) annualized all-cause healthcare expenditure was $60,599 ($52,112-$66,716) among patients with NMOSD versus $8,912 ($7,084-$10,727) among matched comparators. Mean (95% CI) annualized expenditure attributed to NMOSD was $51,687 ($43,820-$58,664), of which 49% was for inpatient care and 51% was for ambulatory services. Hospitalizations with a principal diagnosis of neuromyelitis optica, transverse myelitis, optic neuritis, or other NMOSD-related conditions accounted for 51% of the total attributed expenditure in the inpatient setting. Use of rituximab (33%) and immunoglobulin (6%) accounted for 39% of the attributed expenditure in the outpatient setting. Treatment for acute relapses was the largest, single cost category.

Conclusions

Findings of this large retrospective study indicate that annual healthcare expenditure attributed to NMOSD in US clinical practice is over $50,000 per patient. A considerable component of this expenditure is associated with relapse-related care, especially in the inpatient setting.

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Neuromyelitis Optica and Anti-MOG Disease Poster Presentation

P0749 - Relapses and associated healthcare resource utilization among patients with neuromyelitis optica spectrum disorder in US clinical practice (ID 785)

Speakers
Presentation Number
P0749
Presentation Topic
Neuromyelitis Optica and Anti-MOG Disease

Abstract

Background

Little is known about the frequency of relapses and relapse-associated healthcare resource utilization (HCRU) among patients with neuromyelitis optica spectrum disorder (NMOSD), a rare, autoimmune condition characterized by unpredictable relapses affecting the optic nerves and spinal cord that can lead to blindness, paralysis, and premature death.

Objectives

A retrospective, observational cohort analysis was conducted to characterize the rate of relapses and relapse-associated HCRU among patients with NMOSD in US clinical practice.

Methods

Data from the IQVIA PharMetrics Plus Healthcare Claims Database were used to identify adults (aged ≥18 years) with evidence of NMOSD (≥1 inpatient diagnosis or ≥2 outpatient diagnoses) between January 2013 and March 2018. Relapses were defined by hospital admissions for NMOSD-related conditions and ambulatory encounters for disease-related treatment. Relapse-associated HCRU was characterized by care setting, relapse duration, reason for admission (inpatient), and drug therapy (outpatient). Relapse rates per patient were annualized to adjust for differential follow-up (maximum 6 years). HCRU was described per relapse.

Results

The study population included 1,363 patients with NMOSD. The mean age was 45 years (standard deviation [SD]: 13 years), 75% of the cohort was female, and many patients had a recent history of drug therapy. The mean follow-up duration was 2.4 years (SD: 1.5 years). Among all patients, the annualized number of relapses was 0.8 (95% confidence interval [CI]: 0.7–0.9), and the annualized relapse duration was 12.8 days (95% CI: 11.2-14.4 days). Among patients with ≥1 relapse (48% of all patients), 28% had a relapse duration of <5 days, 18% had a relapse duration of 5-9 days, 18% had a relapse duration of 10-19 days, and 36% had a relapse duration of ≥20 days. More than one-third of all relapses required inpatient care (1 diagnosis: neuromyelitis optica 66%; optic neuritis 10%; transverse myelitis 20%). The mean hospital length of stay was 14.6 days (95% CI: 13.9-15.2 days). Relapses requiring outpatient care were typically treated with intravenous (IV) methylprednisolone (60%), IV immunoglobulin (36%), and/or plasma exchange (11%).

Conclusions

In this large study of patients with NMOSD in US clinical practice, almost one-half of patients experienced ≥1 relapse during follow-up. Among these patients, most experienced multiple relapses, and relapses requiring extended hospital stays were common.

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