Secondary progressive multiple sclerosis: a systematic review of costs and health state utilities

Chataway, Jeremy; Murphy, Niamh; Khurana, Vivek; Schofield, Helen; Findlay, John A.; Adlard, Nicholas

doi:10.1080/03007995.2021.1904860

Cited by 10 publications

(6 citation statements)

References 53 publications

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“…The mean, total costs of the whole cohort were estimated as £5623 per quarter (equivalent to £22,492 over 1-year), but were higher for patients with 8.0 ≤ EDSS ≤ 9.5, at £32,717 (equivalent to £130,868 over 1-year) mainly due to increased hospitalisation. The association between healthcare costs and EDSS disability scores has been documented previously for patients with multiple sclerosis [31]. Patients with NMOSD report low utility scores on the EQ-5D-5L.…”

Section: Principal Findingsmentioning

confidence: 58%

Health utilities and costs for neuromyelitis optica spectrum disorder

Hughes

Bourke

Jones

et al. 2022

Orphanet J Rare Dis

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Background Neuromyelitis optica spectrum disorder (NMOSD) is a rare, neurological disease that places a significant burden on patients, their carers, and healthcare systems. Objectives To estimate patient and carer health utilities and costs of NMOSD within the UK setting. Methods Patients with NMOSD and their carers, recruited via a regional specialist treatment centre, completed a postal questionnaire that included a resource use measure, the EuroQoL (EQ)-5D-5L, EQ-5D-VAS, Vision and Quality of Life Index (VisQoL), Carer Experience Survey (CES) and the Expanded Disability Status Scale (EDSS). The questionnaire asked about respondents’ use of health and community care services, non-medical costs, informal care and work capacity. Data were analysed descriptively. Uncertainties in costs and utilities were assessed using bootstrap analysis. Results 117 patients and 74 informal carers responded to the survey. Patients’ mean EQ-5D-5L and VisQoL health utilities (95% central range) were 0.54 (− 0.29, 1.00) and 0.79 (0.11, 0.99), respectively. EQ-5D-5L utility decreased with increasing EDSS score bandings, from 0.80 (0.75, 0.85) for EDSS ≤ 4.0, to 0.20 (− 0.29, 0.56) for EDSS 8.0 to 9.5. Mean, 3-month total costs were £5623 (£2096, £12,156), but ranged from £562 (£381, £812) to £32,717 (£2888, £98,568) for these EDSS bandings. Carer-reported EQ-5D-5L utility and CES index scores were 0.85 (0.82, 0.89) and 57.67 (52.69, 62.66). Mean, 3-month costs of informal care were £13,150 to £24,560. Conclusions NMOSD has significant impacts on health utilities and NHS and carer costs. These data can be used as inputs to cost-effectiveness analyses of new medicines for NMOSD.

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Section: Principal Findingsmentioning

confidence: 58%

Health utilities and costs for neuromyelitis optica spectrum disorder

Hughes

Bourke

Jones

et al. 2022

Orphanet J Rare Dis

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“…PPMS and SPMS share similar pathophysiology and comparable rates of disease progression [9]; however, both populations are clinically distinct from RRMS. Compared with RRMS, progressive MS is clinically associated with greater symptom severity and functional impairment, higher rates of unemployment and hospitalization [3], greater economic burden, and a more substantial impact on health-related quality of life [36].…”

Section: Introductionmentioning

confidence: 99%

Treatment Patterns and Unmet Need for Patients with Progressive Multiple Sclerosis in the United States: Survey Results from 2016 to 2021

Watson,

Thirumalai,

Barlev

et al. 2023

Neurol Ther

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Introduction: Much of the current literature on treatment patterns and disability progression in multiple sclerosis (MS) does not distinguish between the relapsing-remitting and progressive subtypes (including primary [PPMS] and secondary progressive MS [SPMS]), or between active/nonactive disease. Current treatment options for progressive MS are limited, with only one approved product for PPMS and none specifically for nonactive SPMS. Here we report treatment patterns, disability progression, and unmet needs among patients with active and nonactive PPMS and SPMS. Methods: The annual, cross-sectional survey from the Adelphi Disease Specific Program was used to collect physician-reported data on US adult patients with PPMS and SPMS, including active and nonactive disease. Treatment patterns (including the proportion of patients who were untreated with a disease-modifying therapy [DMT]), disability progression, and unmet need are described from 2016 to 2021. Results: Data were collected for 2067 patients with progressive MS (PPMS, 1583; SPMS, 484). A substantial proportion of patients were untreated across all groups, and this was highest for nonactive PPMS (* 43%). The proportion of untreated patients generally declined over time but remained high in 2018-2021 (* 10-38%). Among treated patients, the proportion receiving infusions increased over time to * 34-46%, largely driven by ocrelizumab use after approval. Disability progression was reported for most patients ([ 50%), including many who were receiving a DMT. Across all disease subtypes, when physicians were asked about the greatest unmet need with current DMTs, they

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“…The societal economic burden varies between MS types: an analysis of seven European cost-of-illness analyses computed that mean annual costs per patient were €31,007 (in 2021 values) for relapsing-remitting MS and €58,475 for secondary progressive MS ( 13 ). With respect to their breakdown, indirect costs and direct non-medical costs accounted for more than half of societal costs of secondary progressive MS. Our literature search did not identify a review focusing on the economic burden of primary progressive MS.…”

Section: Resultsmentioning

confidence: 99%

Societal economic burden of multiple sclerosis and cost-effectiveness of disease-modifying therapies

Simoens

2022

Front. Neurol.

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BackgroundIn an era of scarce resources, policy makers, neurologists and other stakeholders need to be aware of the economic burden of multiple sclerosis and the cost-effectiveness of disease-modifying therapies. The aim of this article is to provide a mini-review of these health economic facets of multiple sclerosis.MethodsAn umbrella review was conducted by searching PubMed and Google Scholar from 2002 until June 2022 for peer-reviewed systematic and narrative literature reviews.ResultsAn extensive body of evidence corroborates that multiple sclerosis is associated with a substantial economic burden within and outside the health care sector, that costs of secondary progressive multiple sclerosis exceed those of relapsing-remitting multiple sclerosis, that costs increase with disease severity and are influenced by the occurrence of relapses and therapy adherence. However, cost estimates and their breakdown into various components vary between countries. Economic evaluations show that disease-modifying therapies for relapsing-remitting multiple sclerosis are generally not cost-effective, but these results depend on the local setting. Cost-effectiveness of disease-modifying therapies improves when a societal perspective is taken and efficacy does not wane over a lifetime horizon, when oral administration forms or dosing strategies requiring less maintenance are introduced, and when generic versions enter the market. Reimbursement recommendations related to disease-modifying therapies also differ between countries.ConclusionThe local context matters when calculating the societal economic burden of multiple sclerosis and the cost-effectiveness of disease-modifying therapies.

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Secondary progressive multiple sclerosis: a systematic review of costs and health state utilities

Cited by 10 publications

References 53 publications

Health utilities and costs for neuromyelitis optica spectrum disorder

Health utilities and costs for neuromyelitis optica spectrum disorder

Treatment Patterns and Unmet Need for Patients with Progressive Multiple Sclerosis in the United States: Survey Results from 2016 to 2021

Societal economic burden of multiple sclerosis and cost-effectiveness of disease-modifying therapies

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