Health economics of disease-modifying therapy for multiple sclerosis in the United States

Hartung, Daniel

doi:10.1177/1756286420987031

Cited by 37 publications

(31 citation statements)

References 47 publications

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“…29 It is important to note that as the cost of DMTs rises and the affordability decreases, patients may be deterred from starting DMTs or be forced to interrupt their therapy. 30 The total economic burden of MS estimated in this study was higher than estimates in prior United States-based studies.…”

Section: Discussioncontrasting

confidence: 67%

The Economic Burden of Multiple Sclerosis in the United States

et al. 2022

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Background and Objectives:A recent report estimated that approximately one million adults were living with multiple sclerosis (MS) in the United States (US). While MS is rarely the direct cause of death, its debilitating effects on normal body functions can result in considerable disruption to daily living and life roles including work, physical independence, mobility, social interaction, and participation in leisure activities. This study estimated the total economic burden of MS in the US in 2019.Methods:This study used a prevalence-based approach to estimate the national economic burden of MS. Claims from three sources (Medicare Current Beneficiary Survey, Medicare Standard Analytical File, and Optum de-identified Normative Health Information System) were used to obtain direct costs, while a survey was developed to collect indirect costs (e.g., labor market productivity losses, costs of paid and unpaid caregivers, home modification) from 946 patients with MS (PwMS). Direct medical costs reflected the difference in the total average annual amount paid for PwMS versus matched controls without MS. Future earnings loss due to premature death attributable to MS was calculated using Centers for Disease Control and Prevention mortality data and Medicare claims data.Results:The estimated total economic burden was $85.4 billion, with a direct medical cost of $63.3 billion and indirect and non-medical costs of $22.1 billion. Retail prescription medication (54%), clinic administered drugs (12%), medication and administration, and outpatient care (9%) were the three largest components of the direct costs. The average excess per person annual medical costs for PwMS was $65,612; at $35,154 per person, disease-modifying therapies (DMTs) accounted for the largest proportion of this cost. The cost per DMT user ranged from $57,202 to $92,719, depending on gender-age strata.The average indirect and non-medical costs were $18,542 per PwMS and $22,875 per PwMS if caregivers’ costs were included. Lost earnings due to premature death, presenteeism, and absenteeism losses were the largest indirect cost components.Discussion:MS is a very costly chronic disease, with direct costs of prescription drugs and indirect productivity loss being the significant cost drivers. Our findings suggested that the burden of MS in the US has been underestimated.

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Section: Discussioncontrasting

confidence: 67%

The Economic Burden of Multiple Sclerosis in the United States

et al. 2022

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“…The direct and indirect healthcare costs of MS treatment are substantial [ 66 ]. The costs have risen rapidly over the last several decades and are driven by the escalating cost of DMTs [ 67 ].…”

Section: Adherencementioning

confidence: 99%

“…High and rising costs for MS DMTs are a major concern for patients and society. The treatment costs are $90,000 a year on average [ 66 ]. The high costs of DMT place a financial burden on a healthcare system and negatively impact patients because of unaffordable out-of-pocket costs and excessive restrictions by insurance companies.…”

Section: Adherencementioning

confidence: 99%

Adherence to Therapy in Patients with Multiple Sclerosis—Review

Kołtuniuk

Chojdak-Łukasiewicz

2022

IJERPH

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Multiple sclerosis (MS) is a chronic, autoimmune, demyelinating disease of the central nervous system (CNS). MS is an incurable disease. The goal of disease-modifying therapies (DMT) is to slow the progression of the disease, prevent relapses and increase the patient’s overall quality of life. According to the World Health Organisation definition, adherence means the extent to which a person’s medication-taking behaviour corresponds with the agreed upon treatment recommendations from a healthcare provider. Accurate adherence is necessary for efficient treatment. Non-adherence is related to unsuccessful treatments, the risk of relapses and increased healthcare costs. The aim of this study is to present the main factors relating to non-adherence in MS patients.

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“…How quickly this will be implemented is a different matter. Patients’ choice, intolerable side effects, pregnancy therapy restrictions, and the added burden to healthcare budgets are just some of the obstacles that stand in the way [ 7 ].…”

Section: Resultsmentioning

confidence: 99%

Predictive MRI Biomarkers in MS—A Critical Review

et al. 2022

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Background and Objectives: In this critical review, we explore the potential use of MRI measurements as prognostic biomarkers in multiple sclerosis (MS) patients, for both conventional measurements and more novel techniques such as magnetization transfer, diffusion tensor, and proton spectroscopy MRI. Materials and Methods: All authors individually and comprehensively reviewed each of the aspects listed below in PubMed, Medline, and Google Scholar. Results: There are numerous MRI metrics that have been proven by clinical studies to hold important prognostic value for MS patients, most of which can be readily obtained from standard 1.5T MRI scans. Conclusions: While some of these parameters have passed the test of time and seem to be associated with a reliable predictive power, some are still better interpreted with caution. We hope this will serve as a reminder of how vast a resource we have on our hands in this versatile tool—it is up to us to make use of it.

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Health economics of disease-modifying therapy for multiple sclerosis in the United States

Cited by 37 publications

References 47 publications

The Economic Burden of Multiple Sclerosis in the United States

The Economic Burden of Multiple Sclerosis in the United States

Adherence to Therapy in Patients with Multiple Sclerosis—Review

Predictive MRI Biomarkers in MS—A Critical Review

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