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Author Of 4 Presentations

Neuromyelitis Optica and Anti-MOG Disease Poster Presentation

P0689 - Autoimmune comorbidity increases healthcare cost burden in patients with NMOSD in the United States: a retrospective commercial claims analysis   (ID 1053)

Speakers
Presentation Number
P0689
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 may be associated with specific comorbidities, including autoimmune disease (AID) or nonautoimmune conditions. This study assessed real-world healthcare utilization and cost of illness in patients with NMOSD and overlapping AID.

Objectives

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

Methods

Methods

Claims data from the Truven Health MarketScan Commercial and Medicare Supplemental Databases were analyzed 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 AID in consumer price index–adjusted 2019 US dollars within 12 months post–index date were calculated for each patient.

Results

In the NMOSD group, 31/162 patients (19.1%) had AID compared with 40/810 matched non-NMOSD controls (4.9%), with 8/162 (4.9%) in the NMSOD group having multiple AIDs vs 5/810 (0.6%) in matched non-NMOSD controls. These included systemic lupus erythematous (SLE; 5.6% vs 0.4%; p<0.001), rheumatoid arthritis (RA; 4.3% vs 0.9%; p=0.004), Sjögren syndrome (SS; 3.1% vs 0.1%; p<0.001), and autoimmune encephalitis (AE; 2.5% vs 0%; p<0.001). Total median [IQR] costs per patient during the post-index follow-up period were significantly higher for patients with NMOSD and AID ($68,386 [$23,374–$160,863]) than both matched non-NMOSD controls with AID ($17,215 [$6,715–$31,442]; p<0.001) and NMOSD without AID ($23,905 [$8,633–$67,252]; p=0.022). This trend held across all settings, including inpatient care, outpatient care, outpatient emergency room services and pharmacy expenses.

Conclusions

Patients with NMOSD and comorbid AID incurred significantly higher costs associated with healthcare resource utilization compared with matched non-NMOSD controls and patients with NMOSD who did not have AID. These results demonstrate a higher cost burden associated with overlapping AID (primarily SLE, RA, SS and AE) in patients with NMOSD and a need to identify more cost-efficient, integrated therapeutic approaches to address the overlap of NMOSD and other serious, debilitating AID.

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Neuromyelitis Optica and Anti-MOG Disease Poster Presentation

P0694 - Burden of autoimmune comorbidity in patients with NMOSD in the United States revealed by retrospective commercial claims analysis (ID 1051)

Speakers
Presentation Number
P0694
Presentation Topic
Neuromyelitis Optica and Anti-MOG Disease

Abstract

Background

Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune condition of the central nervous system that may be associated with concomitant autoimmune disease (CAID), such as systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA), as well as nonautoimmune conditions (CnAID).

Objectives

To evaluate the burden of CAID in patients with NMOSD compared with controls without NMOSD (non-NMOSD) in US commercial claims databases.

Methods

Claims data from the Truven Health MarketScan Commercial and Medicare Supplemental Databases were analyzed 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. The Charlson Comorbidity Index (CCI) was assessed during a 6-month baseline period prior to NMOSD diagnosis and at 12 months post-index. Comorbidities during the 12-month follow-up period were evaluated.

Results

A total of 162 patients with NMOSD (mean [SD] age, 43.3 [18] years) and 810 non-NMOSD controls (mean [SD] age, 43.3 [18] years) were evaluated. Mean (SD) 6-month baseline and 12-month follow-up CCI scores were 0.96 (1.77) and 1.62 (2.53) for patients with NMOSD vs 0.34 (0.91) and 0.52 (1.31) for non-NMOSD controls, respectively (p<0.001). CAID occurred in 19.1% vs 4.9% (p<0.001) of NMOSD patients vs non-NMOSD controls. SLE (5.6% vs 0.4%; p<0.001), RA (4.3% vs 0.9%; p=0.004), Sjögren syndrome (3.1% vs 0.1%; p<0.001) and autoimmune encephalitis (2.5% vs 0%; p<0.001) occurred at significantly higher prevalence in patients with NMOSD. Reports of type 1 diabetes (1.9% vs 1.4%) and myasthenia gravis (1.2% vs 0.1%) were not significantly different between the NMOSD and non-NMOSD groups in this study cohort.

Conclusions

Patients with NMOSD had significantly higher CCI scores and CAID prevalence compared with controls. Consistent with previous studies, these results highlight the significant CAID burden in NMOSD. Moreover, these data suggest immune dysfunction common to multiple autoimmune diseases and underscore the need to identify efficacious therapies with distinct mechanisms of action to address the concomitant burden of NMOSD and other debilitating CAIDs.

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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
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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Neuromyelitis Optica and Anti-MOG Disease Poster Presentation

P0712 - Estimating the cost of illness for patients with neuromyelitis optica spectrum disorder from US commercial claims (ID 984)

Speakers
Presentation Number
P0712
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 leads to accumulation of severe disability. Patients with highly active NMOSD have a roughly 10-times higher hospital inpatient admission rate compared with patients without NMOSD. Limited data have been published on the cost of illness for patients with NMOSD, including treatment with rescue therapies (RTs) and use of health services in the emergency room (ER) and inpatient hospital settings.

Objectives

To evaluate the cost of illness related to ER visits, hospitalizations and RTs in patients with NMOSD compared with controls without NMOSD (non-NMOSD) 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 NMO 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 of ER visits and hospitalizations in consumer price index–adjusted 2019 US dollars within 12 months post–index date were calculated for each patient.

Results

A total of 162 patients with NMOSD (mean [SD] age, 43.3 [18] years) and 810 non-NMOSD controls (mean [SD] age, 43.3 [18] years) were evaluated. ER visits and hospitalizations for NMOSD vs non-NMOSD groups occurred in 35.8% vs 16.9% and 41.4% vs 5.1% of patients (p<0.001 for both), and mean (SD) time in hospital was 21.2 (32.7) vs 5.24 (6.46; p<0.001) days, respectively. Nearly 12% of patients with NMOSD were treated with RTs (intravenous immunoglobulin [IVIG] or plasma exchange [PLEX]) vs none for non-NMOSD controls. Mean (SD) costs per patient were $2,400 ($7,771) vs $408 ($2,579) for ER visits, $29,054 ($144,872) vs $1,521 ($10,759) for hospitalizations and $912.73 ($5,032.75) vs $0 for IVIG/PLEX for the NMOSD vs non-NMOSD groups (p<0.001 for all).

Conclusions

Compared with controls, patients with NMOSD had significantly longer hospital stays and higher costs associated with ER visits, hospitalizations and RTs. These results highlight the severity of NMOSD, the economic burden of illness, and the unmet need for more safe and effective treatments.

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Presenter Of 4 Presentations

Neuromyelitis Optica and Anti-MOG Disease Poster Presentation

P0689 - Autoimmune comorbidity increases healthcare cost burden in patients with NMOSD in the United States: a retrospective commercial claims analysis   (ID 1053)

Speakers
Presentation Number
P0689
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 may be associated with specific comorbidities, including autoimmune disease (AID) or nonautoimmune conditions. This study assessed real-world healthcare utilization and cost of illness in patients with NMOSD and overlapping AID.

Objectives

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

Methods

Methods

Claims data from the Truven Health MarketScan Commercial and Medicare Supplemental Databases were analyzed 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 AID in consumer price index–adjusted 2019 US dollars within 12 months post–index date were calculated for each patient.

Results

In the NMOSD group, 31/162 patients (19.1%) had AID compared with 40/810 matched non-NMOSD controls (4.9%), with 8/162 (4.9%) in the NMSOD group having multiple AIDs vs 5/810 (0.6%) in matched non-NMOSD controls. These included systemic lupus erythematous (SLE; 5.6% vs 0.4%; p<0.001), rheumatoid arthritis (RA; 4.3% vs 0.9%; p=0.004), Sjögren syndrome (SS; 3.1% vs 0.1%; p<0.001), and autoimmune encephalitis (AE; 2.5% vs 0%; p<0.001). Total median [IQR] costs per patient during the post-index follow-up period were significantly higher for patients with NMOSD and AID ($68,386 [$23,374–$160,863]) than both matched non-NMOSD controls with AID ($17,215 [$6,715–$31,442]; p<0.001) and NMOSD without AID ($23,905 [$8,633–$67,252]; p=0.022). This trend held across all settings, including inpatient care, outpatient care, outpatient emergency room services and pharmacy expenses.

Conclusions

Patients with NMOSD and comorbid AID incurred significantly higher costs associated with healthcare resource utilization compared with matched non-NMOSD controls and patients with NMOSD who did not have AID. These results demonstrate a higher cost burden associated with overlapping AID (primarily SLE, RA, SS and AE) in patients with NMOSD and a need to identify more cost-efficient, integrated therapeutic approaches to address the overlap of NMOSD and other serious, debilitating AID.

Collapse
Neuromyelitis Optica and Anti-MOG Disease Poster Presentation

P0694 - Burden of autoimmune comorbidity in patients with NMOSD in the United States revealed by retrospective commercial claims analysis (ID 1051)

Speakers
Presentation Number
P0694
Presentation Topic
Neuromyelitis Optica and Anti-MOG Disease

Abstract

Background

Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune condition of the central nervous system that may be associated with concomitant autoimmune disease (CAID), such as systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA), as well as nonautoimmune conditions (CnAID).

Objectives

To evaluate the burden of CAID in patients with NMOSD compared with controls without NMOSD (non-NMOSD) in US commercial claims databases.

Methods

Claims data from the Truven Health MarketScan Commercial and Medicare Supplemental Databases were analyzed 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. The Charlson Comorbidity Index (CCI) was assessed during a 6-month baseline period prior to NMOSD diagnosis and at 12 months post-index. Comorbidities during the 12-month follow-up period were evaluated.

Results

A total of 162 patients with NMOSD (mean [SD] age, 43.3 [18] years) and 810 non-NMOSD controls (mean [SD] age, 43.3 [18] years) were evaluated. Mean (SD) 6-month baseline and 12-month follow-up CCI scores were 0.96 (1.77) and 1.62 (2.53) for patients with NMOSD vs 0.34 (0.91) and 0.52 (1.31) for non-NMOSD controls, respectively (p<0.001). CAID occurred in 19.1% vs 4.9% (p<0.001) of NMOSD patients vs non-NMOSD controls. SLE (5.6% vs 0.4%; p<0.001), RA (4.3% vs 0.9%; p=0.004), Sjögren syndrome (3.1% vs 0.1%; p<0.001) and autoimmune encephalitis (2.5% vs 0%; p<0.001) occurred at significantly higher prevalence in patients with NMOSD. Reports of type 1 diabetes (1.9% vs 1.4%) and myasthenia gravis (1.2% vs 0.1%) were not significantly different between the NMOSD and non-NMOSD groups in this study cohort.

Conclusions

Patients with NMOSD had significantly higher CCI scores and CAID prevalence compared with controls. Consistent with previous studies, these results highlight the significant CAID burden in NMOSD. Moreover, these data suggest immune dysfunction common to multiple autoimmune diseases and underscore the need to identify efficacious therapies with distinct mechanisms of action to address the concomitant burden of NMOSD and other debilitating CAIDs.

Collapse
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
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.

Collapse
Neuromyelitis Optica and Anti-MOG Disease Poster Presentation

P0712 - Estimating the cost of illness for patients with neuromyelitis optica spectrum disorder from US commercial claims (ID 984)

Speakers
Presentation Number
P0712
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 leads to accumulation of severe disability. Patients with highly active NMOSD have a roughly 10-times higher hospital inpatient admission rate compared with patients without NMOSD. Limited data have been published on the cost of illness for patients with NMOSD, including treatment with rescue therapies (RTs) and use of health services in the emergency room (ER) and inpatient hospital settings.

Objectives

To evaluate the cost of illness related to ER visits, hospitalizations and RTs in patients with NMOSD compared with controls without NMOSD (non-NMOSD) 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 NMO 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 of ER visits and hospitalizations in consumer price index–adjusted 2019 US dollars within 12 months post–index date were calculated for each patient.

Results

A total of 162 patients with NMOSD (mean [SD] age, 43.3 [18] years) and 810 non-NMOSD controls (mean [SD] age, 43.3 [18] years) were evaluated. ER visits and hospitalizations for NMOSD vs non-NMOSD groups occurred in 35.8% vs 16.9% and 41.4% vs 5.1% of patients (p<0.001 for both), and mean (SD) time in hospital was 21.2 (32.7) vs 5.24 (6.46; p<0.001) days, respectively. Nearly 12% of patients with NMOSD were treated with RTs (intravenous immunoglobulin [IVIG] or plasma exchange [PLEX]) vs none for non-NMOSD controls. Mean (SD) costs per patient were $2,400 ($7,771) vs $408 ($2,579) for ER visits, $29,054 ($144,872) vs $1,521 ($10,759) for hospitalizations and $912.73 ($5,032.75) vs $0 for IVIG/PLEX for the NMOSD vs non-NMOSD groups (p<0.001 for all).

Conclusions

Compared with controls, patients with NMOSD had significantly longer hospital stays and higher costs associated with ER visits, hospitalizations and RTs. These results highlight the severity of NMOSD, the economic burden of illness, and the unmet need for more safe and effective treatments.

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