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Gallehzan NA, Khosravi M, Jamebozorgi K, Mir N, Jalilian H, Soleimanpour S, Hoseini S, Rezapour A, Eshraghi A. Cost-utility and cost-effectiveness analysis of disease-modifying drugs of relapsing-remitting multiple sclerosis: a systematic review. HEALTH ECONOMICS REVIEW 2024; 14:12. [PMID: 38363408 PMCID: PMC10870486 DOI: 10.1186/s13561-024-00478-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 01/11/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic, autoimmune, and inflammatory disease. The economic burden of MS is substantial, and the high cost of Disease-modifying drugs (DMDs) prices are the main drivers of healthcare expenditures. We conducted a systematic review of studies evaluating the cost-utility and cost-effectiveness of DMDs for relapsing-remitting multiple sclerosis (RRMS). MATERIALS AND METHOD Searches were conducted in PubMed, Web of Science, Scopus, and Embase. The search covered articles published between May 2001 and May 2023. Studies that were written in English and Persian and examined the cost-utility and cost-effectiveness of DMDs in patients with MS were included in our review. Data extraction was guided by the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist, and the quality of economic evaluations was assessed using the Quality of Health Economics Studies Instrument (QHES). All costs were converted to 2020 U.S. dollars using Purchasing Power Parity (PPP). RESULTS The search yielded 1589 studies, and 49 studies were eligible for inclusion. The studies were mainly based on a European setting. Most studies employed Markov model to assess the cost-effectiveness. The lowest and highest numerical value of outcome measures were -1,623,918 and 2,297,141.53, respectively. Furthermore, the lowest and highest numerical value of the cost of DMDs of RRMS were $180.67, and $1474840.19, respectively. CONCLUSIONS Based on the results of all studies, it can be concluded that for the treatment of patients with MS, care-oriented strategies should be preferred to drug strategies. Also, among the drug strategies with different prescribing methods, oral disease-modifying drugs of RRMS should be preferred to injectable drugs and intravenous infusions.
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Affiliation(s)
- Nasrin Abulhasanbeigi Gallehzan
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Khosravi
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
| | | | - Nazanin Mir
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Habib Jalilian
- Department of Health Services Management, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Samira Soleimanpour
- Department of Medical Library and Information Science, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Hoseini
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Eshraghi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
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Javier-Ormazábal A, González-Platas M, Jiménez-Sosa A, Herrero P, Lapuente-Hernández D. The Effectiveness of a Single Dry Needling Session on Gait and Quality of Life in Multiple Sclerosis: A Double-Blind Randomized Sham-Controlled Pilot Trial. Healthcare (Basel) 2023; 12:10. [PMID: 38200916 PMCID: PMC10778988 DOI: 10.3390/healthcare12010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Gait disorders are a major cause of disability and reduced health-related quality of life in people with multiple sclerosis (pwMS). Dry needling (DN) has demonstrated positive results to improve gait parameters in patients with stroke. The main aim of this study was to evaluate the effect of a single session of DN in the gait performance of pwMS. METHODS A double-blind parallel randomized sham-controlled pilot trial was conducted. Study participants received a single session of active DN or sham DN in the gastrocnemius medialis muscle. Pre-treatment and immediately post-treatment measurements were taken, as well as at one and four weeks after the intervention. Outcomes related to gait performance (Timed 25-Foot Walk), self-perceived walking capacity (Multiple Sclerosis Walking Scale), risk of falls (Timed Up and Go test), disability level (Expanded Disability Status Score) and quality of life (Multiple Sclerosis Quality of Life-54 questionnaire and Analogic Quality of Life scale) were evaluated. RESULTS 18 patients who had multiple sclerosis participated in the study. The group who received active DN showed within-group significant statistical differences immediately after treatment for gait performance (p = 0.008) and risk of falls (p = 0.008), as well as for self-perceived walking capacity at one week (p = 0.017) and four weeks (p = 0.011) and quality of life at four weeks (p = 0.014). Regarding the comparison between groups, only significant results were obtained in the physical domain of the quality of life at four weeks (p = 0.014). CONCLUSIONS DN seems to be a promising therapeutic tool for the treatment of gait disorders in pwMS. However, when results were compared with sham DN, no differences were found.
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Affiliation(s)
- Alberto Javier-Ormazábal
- Division of Physiotherapy, Hospital Universitario de Canarias, Carretera Ofra S/N, 38320 San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
- Research Institute of Biomedical and Health Sciences, Universidad de Las Palmas de Gran Canaria, C. Juan de Quesada 30, 35001 Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Montserrat González-Platas
- Research Institute of Biomedical and Health Sciences, Universidad de Las Palmas de Gran Canaria, C. Juan de Quesada 30, 35001 Las Palmas de Gran Canaria, Las Palmas, Spain
- Division of Neurology, Hospital Universitario de Canarias, Carretera Ofra S/N, 38320 San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
| | - Alejandro Jiménez-Sosa
- Research Unit, Hospital Universitario de Canarias, Carretera Ofra S/N, 38320 San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
| | - Pablo Herrero
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Zaragoza, Spain
- iHealthy Research Group, IIS Aragon, Avda San Juan Bosco 13, 50009 Zaragoza, Zaragoza, Spain
| | - Diego Lapuente-Hernández
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Zaragoza, Spain
- iHealthy Research Group, IIS Aragon, Avda San Juan Bosco 13, 50009 Zaragoza, Zaragoza, Spain
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Ginestal R, Rubio-Terrés C, Morán OD, Rubio-Rodríguez D, Los Santos HD, Ordoñez C, Sánchez-Magro I. Cost-effectiveness of cladribine tablets and dimethyl fumarate in the treatment of relapsing remitting multiple sclerosis in Spain. J Comp Eff Res 2023; 12:e220193. [PMID: 36705064 PMCID: PMC10288949 DOI: 10.2217/cer-2022-0193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/19/2022] [Indexed: 01/28/2023] Open
Abstract
Aim: To analyze the cost-effectiveness of treatment of relapsing remitting multiple sclerosis (RRMS) with cladribine tablets (CladT) and dimethyl fumarate (DMF) from the perspective of the Spanish National Health System (NHS). Methods: A probabilistic Markov model (second-order Monte Carlo simulation) with a 10-year time horizon and annual Markov cycles was performed. Results: CladT was the dominant treatment, with lower costs (-74,741 € [95% CI: -67,247; -85,661 €]) and greater effectiveness (0.1920 [95% CI: -0.1659; 0.2173] QALY) per patient, compared with DMF. CladT had a 95.1% probability of being cost-effective and a 94.1% chance of being dominant compared with DMF. Conclusion: CladT is the dominant treatment (lower costs, with more QALYs) compared with DMF in the treatment of RRMS in Spain.
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Affiliation(s)
- Ricardo Ginestal
- Hospital Clínico San Carlos, Neurology Department, C/ Prof Martín Lagos, 28040 Madrid, Spain
| | | | - Olga Durán Morán
- Merck, SLU, C/ María de Molina, 40, 28006 Madrid, Spain, an affiliate of Merck KGaA
| | | | - Heidi De Los Santos
- Merck, SLU, C/ María de Molina, 40, 28006 Madrid, Spain, an affiliate of Merck KGaA
| | - Cristina Ordoñez
- Merck, SLU, C/ María de Molina, 40, 28006 Madrid, Spain, an affiliate of Merck KGaA
| | - Isabel Sánchez-Magro
- Merck, SLU, C/ María de Molina, 40, 28006 Madrid, Spain, an affiliate of Merck KGaA
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Vudumula U, Patidar M, Gudala K, Karpf E, Adlard N. Evaluating the impact of early vs delayed ofatumumab initiation and estimating the long-term outcomes of ofatumumab vs teriflunomide in relapsing multiple sclerosis patients in Spain. J Med Econ 2023; 26:11-18. [PMID: 36472139 DOI: 10.1080/13696998.2022.2151270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To evaluate the impact of early (at first-line) vs delayed (3-year delay) ofatumumab initiation and long-term clinical, societal, and economic outcomes of ofatumumab vs teriflunomide in relapsing multiple sclerosis (RMS) patients from a Spanish societal perspective. METHODS A cost-consequence analysis was conducted using an Expanded Disability Status Scale (EDSS)-based Markov model. Inputs were sourced from ASCLEPIOS I and II trials and published literature. RESULTS At the end of 10 years, compared with first-line teriflunomide treatment, early first-line ofatumumab initiation was projected to result in 35.6% fewer patients progressing to EDSS ≥ 7 and 27.8% fewer relapses. The ofatumumab cohort required 7.3% reduced informal care time and had 19% fewer disability-adjusted life years (DALYs) than the teriflunomide cohort. A 3-year delay in ofatumumab treatment (3-year teriflunomide + 7-year ofatumumab) was projected to result in 32.2% more patients progressing to EDSS ≥ 7, 20.2% more relapses, 5.4% increased informal care time, and 16.6% more DALYs compared with early ofatumumab initiation. Early ofatumumab initiation was associated with total annual cost savings (excluding disease-modifying-therapies' acquisition costs) of €35,328 ($34,549; conversion factor 1€= $1.02255) and €24,373 ($23,836) per patient vs teriflunomide and 3-year delayed ofatumumab initiation, respectively. CONCLUSIONS This study highlights the benefits of early initiation of high-efficacy therapy such as ofatumumab vs its delayed initiation for improving the outcomes in RMS patients (having characteristics similar to those of patients included in the ASCLEPIOS trials). Ofatumumab treatment was projected to provide improved long-term clinical, societal, and economic outcomes vs teriflunomide treatment in RMS patients from a Spanish societal perspective.
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Affiliation(s)
| | - Mausam Patidar
- Patient Access Services, Novartis Healthcare Pvt. Ltd, Hyderabad, India
| | - Kapil Gudala
- Patient Access Services, Novartis Healthcare Pvt. Ltd, Hyderabad, India
| | | | - Nicholas Adlard
- Health Economics and Outcomes Research, Novartis Pharma AG, Basel, Switzerland
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Simoens S. Societal economic burden of multiple sclerosis and cost-effectiveness of disease-modifying therapies. Front Neurol 2022; 13:1015256. [PMID: 36341111 PMCID: PMC9631775 DOI: 10.3389/fneur.2022.1015256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/04/2022] [Indexed: 12/02/2022] Open
Abstract
Background In 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. Methods An umbrella review was conducted by searching PubMed and Google Scholar from 2002 until June 2022 for peer-reviewed systematic and narrative literature reviews. Results An 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. Conclusion The local context matters when calculating the societal economic burden of multiple sclerosis and the cost-effectiveness of disease-modifying therapies.
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Greene N, Araujo L, Campos C, Dalglish H, Gibbs S, Yermilov I. The Economic and Humanistic Burden of Pediatric-Onset Multiple Sclerosis. JOURNAL OF HEALTH ECONOMICS AND OUTCOMES RESEARCH 2022; 9:103-114. [PMID: 36348724 PMCID: PMC9584745 DOI: 10.36469/001c.37992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/29/2022] [Indexed: 06/16/2023]
Abstract
Background: Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system. Pediatric-onset MS (POMS), defined as onset of MS before 18 years of age, is estimated to account for 2% to 5% of the MS population worldwide. Objectives: To conduct a literature review focused on the healthcare resource utilization and cost as well as quality-of-life (QOL) outcomes among patients with POMS. Methods: We conducted a systematic literature review of English-language studies published after September 2010 in MEDLINE and Embase to describe the global economic healthcare resource utilization and costs and humanistic (QOL) burden in patients with POMS. Results: We found 11 studies that reported on healthcare resource utilization, cost, or insurance coverage and 36 studies that reported on QOL outcomes in patients with POMS. Patients with POMS had higher rates of primary care visits (1.41 [1.29-1.54]), hospital visits (10.74 [8.95-12.90]), and admissions (rate ratio, 4.27 [2.92-6.25];OR, 15.2 [12.0-19.1]) compared with healthy controls. Mean per-patient costs in the United States were $5907 across all settings per year of follow-up between 2002 and 2012; mean costs per hospital stay were $38 543 (in 2015 USD) between 2004 and 2013. Three studies reported psychosocial scores between 71.59 and 79.7, and 8 studies reported physical health scores between 74.62 to 82.75 using the Pediatric Quality of Life Measurement Model (PedsQLTM). Twelve studies used the PedsQL™ Multidimensional Fatigue Scale. Mean scores on the self-reported general fatigue scale ranged from 63.15 to 78.5. Quality-of-life scores were lower than those of healthy controls. Discussion: Our review presents a uniquely broad and recent overview of the global economic and humanistic burden of patients with POMS. Additional research on healthcare resource utilization and cost would provide a more robust understanding of the economic burden in this population. Conclusions: Healthcare resource utilization and costs are high in this population, and patients report reduced QOL and significant fatigue compared with healthy children and adolescents.
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Affiliation(s)
- Nupur Greene
- Health Economics & Value Assessment, Sanofi, Cambridge, Massachusetts
| | - Lita Araujo
- Health Economics & Value Assessment, Sanofi, Cambridge, Massachusetts
| | - Cynthia Campos
- PHAR (Partnership for Health Analytic Research), LLC, Beverly Hills, California
| | - Hannah Dalglish
- PHAR (Partnership for Health Analytic Research), LLC, Beverly Hills, California
| | - Sarah Gibbs
- PHAR (Partnership for Health Analytic Research), LLC, Beverly Hills, California
| | - Irina Yermilov
- PHAR (Partnership for Health Analytic Research), LLC, Beverly Hills, California
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Zozaya N, Abdalla F, Casado Moreno I, Crespo-Diz C, Ramírez Gallardo AM, Rueda Soriano J, Alcalá Galán M, Hidalgo-Vega Á. The economic burden of pulmonary arterial hypertension in Spain. BMC Pulm Med 2022; 22:105. [PMID: 35346140 PMCID: PMC8962538 DOI: 10.1186/s12890-022-01906-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background Pulmonary Arterial Hypertension (PAH) is a rare, debilitating, and potentially fatal disease. This study aims to quantify the economic burden of PAH in Spain.
Methods The study was conducted from a societal perspective, including direct and indirect costs associated with incident and prevalent patients. Average annual costs per patient were estimated by multiplying the number of resources consumed by their unit cost, differentiating the functional class (FC) of the patient. Total annual costs per FC were also calculated, taking the 2020 prevalence and incidence ranges into account. An expert committee validated the information on resource consumption and provided primary information on pharmacological consumption. Unit costs were estimated using official tariffs and salaries in Spain. A deterministic sensitivity analysis was conducted to test the uncertainty of the model. Results The average annual total cost was estimated at €98,839 per prevalent patient (FC I-II: €65,233; FC III: €103,736; FC IV: €208,821), being €42,110 for incident patients (FC I-II: €25,666; FC III: €44,667; FC IV: €95,188). The total annual cost of PAH in Spain, taking into account a prevalence between 16.0 and 25.9 cases per million adult inhabitants (FC I-II 31.8%; FC III 61.3%; FC IV 6.9%) and an incidence of 3.7, was estimated at €67,891,405 to €106,131,626, depending on the prevalence considered. Direct healthcare costs accounted for 64% of the total cost, followed by indirect costs (24%), and direct non-healthcare costs (12%). The total costs associated with patients in FC I-II ranged between €14,161,651 and €22,193,954, while for patients in FC III costs ranged between €43,763,019 and €68,391,651, and for patients in FC IV between €9,966,735 and €15,546,021. In global terms, patients with the worst functional status (FC IV) account for only 6.9% of the adults suffering from PAH in Spain, but are responsible for 14.7% of the total costs. Conclusions PAH places a considerable economic burden on patients and their families, the healthcare system, and society as a whole. Efforts must be made to improve the health and management of these patients since the early stages of the disease. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01906-2.
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Affiliation(s)
- Néboa Zozaya
- Department of Health Economics, Weber, Calle Moreto, 17, 5º Dcha., 28014, Madrid, Spain. .,Department of Quantitative Methods in Economics and Management, University Las Palmas de Gran Canaria, Las Palmas, Spain.
| | - Fernando Abdalla
- Department of Health Economics, Weber, Calle Moreto, 17, 5º Dcha., 28014, Madrid, Spain
| | | | - Carlos Crespo-Diz
- Pharmacy Department, Complexo Hospitalario Universitario de Pontevedra, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Pontevedra, Spain
| | | | - Joaquín Rueda Soriano
- Department of Cardiology, Hospital Universitari i Politècnic La Fe, Instituto de Investigación Sanitaria La Fe, CIBERCV, Valencia, Spain
| | | | - Álvaro Hidalgo-Vega
- Weber Foundation, Madrid, Spain.,Department of Economic Analysis and Finances, University of Castilla-La Mancha, Toledo, Spain
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Rezaee M, Morowvat MH, Poursadeghfard M, Radgoudarzi A, Keshavarz K. Cost-effectiveness analysis of rituximab versus natalizumab in patients with relapsing remitting multiple sclerosis. BMC Health Serv Res 2022; 22:118. [PMID: 35090438 PMCID: PMC8796500 DOI: 10.1186/s12913-022-07495-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 01/13/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction Multiple sclerosis (MS) is an inflammatory disease in which the myelin sheaths of the nerve cells in the brain and spinal cord, which are responsible for communication, are destroyed and cause physical signs and symptoms. According to studies, anti-CD20 monoclonal antibodies have significant results in the treatment of this disease. Thus, the aim of the present study was to determine the cost-effectiveness of rituximab against natalizumab in the patients with RRMS in southern Iran in 2020. Methods This is an economic evaluation including cost-effectiveness analysis in which the Markov model with a lifetime horizon was used. The study sample consisted of 120 patients randomly selected from among those referred to the MS Association and the Special Diseases Unit of Shiraz University of Medical Sciences. In this study, the costs were collected from a societal perspective, and the outcomes were obtained in the form of Quality Adjusted Life Years (QALY) and the mean relapse rate. The TreeAge pro 2020 and Excel 2016 software were used for data analysis. Results The comparative study of rituximab and natalizumab showed that the patients receiving rituximab had lower costs ($ 58,307.93 vs. $ 354,174.85) and more QALYs (7.77 vs. 7.65). In addition, the incidence of relapse by rituximab was lower compared to natalizumab (1.15 vs. 2.57). The probabilistic one-way sensitivity analysis showed the robustness of the results. The scatter plots also showed that rituximab was more cost-effective for the patients in 100% of the simulations for the threshold of < $ 37,641. Discussion and conclusion According to the results of this study, rituximab had higher cost-effectiveness than natalizumab. Therefore, it could be a priority for RRMS patients compared to natalizumab because it reduced treatment costs and increased effectiveness.
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Carrera-Hueso FJ, Álvarez-Arroyo L, Poquet-Jornet JE, Vázquez-Ferreiro P, Martínez-Gonzalbez R, El-Qutob D, Ramón-Barrios MA, Martínez-Martínez F, Poveda-Andrés JL, Crespo-Palomo C. Hospitalization budget impact during the COVID-19 pandemic in Spain. HEALTH ECONOMICS REVIEW 2021; 11:43. [PMID: 34734323 PMCID: PMC8565649 DOI: 10.1186/s13561-021-00340-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 09/29/2021] [Indexed: 05/07/2023]
Abstract
OBJECTIVES The aim was to determine the direct impact of the COVID-19 pandemic on Spain's health budget. METHODS Budget impact analyses based on retrospective data from patients with suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) admitted to a Spanish hospital between February 26 and May 21, 2020. Direct medical costs from the perspective of the hospital were calculated. We analyzed diagnostic tests, drugs, medical and nursing care, and isolation ward and ICU stays for three cohorts: patients seen in the emergency room only, hospitalized patients who tested positive for SARS-CoV-2, and patients who tested negative. RESULTS The impact on the hospital's budget for the 3 months was calculated at €15,633,180, 97.4% of which was related to health care and hospitalization. ICU stays accounted for 5.3% of the total costs. The mean cost per patient was €10,744. The main costs were staffing costs (10,131 to 11,357 €/patient for physicians and 10,274 to 11,215 €/patient for nurses). Scenario analysis showed that the range of hospital expenditure was between €14,693,256 and €16,524,924. The median impact of the pandemic on the Spanish health budget in the sensitivity analysis using bootstrapped individual data was €9357 million (interquartile range [IQR], 9071 to 9689) for the conservative scenario (113,588 hospital admissions and 11,664 ICU admissions) and €10,385 million (IQR, 110,030 to 10,758) for the worst-case scenario (including suspected cases). CONCLUSION The impact of COVID-19 on the Spanish public health budget (12.3% of total public health expenditure) is greater than multiple sclerosis, cancer and diabetes cost.
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Affiliation(s)
- F. J. Carrera-Hueso
- Pharmacy Service, University Hospital La Plana, Carretera de Vila-real a Burriana, Km. 0.5, 12540 Villarreal, Castellón, Spain
| | - L. Álvarez-Arroyo
- Pharmacy Service, University Hospital La Plana, Carretera de Vila-real a Burriana, Km. 0.5, 12540 Villarreal, Castellón, Spain
- Pharmacy Doctoral Program at University of Granada, Granada, Spain
| | | | | | - R. Martínez-Gonzalbez
- Informatics and computer Service, University Hospital La Plana, Villarreal (Castelló), Spain
| | - D. El-Qutob
- Allergy Service, University Hospital La Plana, Villarreal (Castelló), Spain
| | | | - F. Martínez-Martínez
- Grupo Investigación de Atención Farmacéutica, Pharmacy and Pharmaceutical Technology Department, University of Granada, Granada, Spain
| | - J. L. Poveda-Andrés
- Pharmacy Department, Hospital Universitari i Politecnic La Fe, Valencia, Spain
| | - C. Crespo-Palomo
- Department G.M. statistics, University of Barcelona, Barcelona, Spain
- Axentiva Solutions, Barcelona, Spain
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Schriefer D, Haase R, Ness NH, Ziemssen T. Cost of illness in multiple sclerosis by disease characteristics - A review of reviews. Expert Rev Pharmacoecon Outcomes Res 2021; 22:177-195. [PMID: 34582300 DOI: 10.1080/14737167.2022.1987218] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Introduction: In light of the increasing number of economic burden studies and heterogeneity in methodology and reporting standards, there is a need for robust evidence synthesis on an umbrella review level.Areas covered: We performed the first review of reviews of cost-of-illness studies in multiple sclerosis. Focusing on disaggregated costs by disease characteristics (disability level, relapse, disease course), we also characterized the underlying methodological evidence base of individual (primary) studies.Expert Commentary: We identified 17 reviews encompassing 111 unique primary studies, and a high degree of overlap across reviews. Costs were substantial, rising with disability level, relapse episodes, and disease progression. Disability was the key cost driver. Compared to mild disability, total costs for moderate disability were 1.4-2.3-fold higher and 1.8-2.9-fold higher for severe disability. With escalating disability, the share of costs outside the health system (indirect costs, informal care) increasingly outweighed the share of direct medical costs. Of all 111 primary studies, 72% gathered resource use/loss data by patient self-report. Associated costs were mostly reported by disability level (75%), followed by relapse (48%) and disease course (21%). In conclusion, although heterogeneity can make in-depth comparisons of costs across studies impossible, important patterns are broadly apparent.
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Affiliation(s)
- Dirk Schriefer
- Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Rocco Haase
- Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | | | - Tjalf Ziemssen
- Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
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Morris K, Nami M, Bolanos JF, Lobo MA, Sadri-Naini M, Fiallos J, Sanchez GE, Bustos T, Chintam N, Amaya M, Strand SE, Mayuku-Dore A, Sakibova I, Biso GMN, DeFilippis A, Bravo D, Tarhan N, Claussen C, Mercado A, Braun S, Yuge L, Okabe S, Taghizadeh-Hesary F, Kotliar K, Sadowsky C, Chandra PS, Tripathi M, Katsaros V, Mehling B, Noroozian M, Abbasioun K, Amirjamshidi A, Hossein-Zadeh GA, Naraghi F, Barzegar M, Asadi-Pooya AA, Sahab-Negah S, Sadeghian S, Fahnestock M, Dilbaz N, Hussain N, Mari Z, Thatcher RW, Sipple D, Sidhu K, Chopra D, Costa F, Spena G, Berger T, Zelinsky D, Wheeler CJ, Ashford JW, Schulte R, Nezami MA, Kloor H, Filler A, Eliashiv DS, Sinha D, DeSalles AAF, Sadanand V, Suchkov S, Green K, Metin B, Hariri R, Cormier J, Yamamoto V, Kateb B. Neuroscience20 (BRAIN20, SPINE20, and MENTAL20) Health Initiative: A Global Consortium Addressing the Human and Economic Burden of Brain, Spine, and Mental Disorders Through Neurotech Innovations and Policies. J Alzheimers Dis 2021; 83:1563-1601. [PMID: 34487051 DOI: 10.3233/jad-215190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Neurological disorders significantly impact the world's economy due to their often chronic and life-threatening nature afflicting individuals which, in turn, creates a global disease burden. The Group of Twenty (G20) member nations, which represent the largest economies globally, should come together to formulate a plan on how to overcome this burden. The Neuroscience-20 (N20) initiative of the Society for Brain Mapping and Therapeutics (SBMT) is at the vanguard of this global collaboration to comprehensively raise awareness about brain, spine, and mental disorders worldwide. This paper aims to provide a comprehensive review of the various brain initiatives worldwide and highlight the need for cooperation and recommend ways to bring down costs associated with the discovery and treatment of neurological disorders. Our systematic search revealed that the cost of neurological and psychiatric disorders to the world economy by 2030 is roughly $16T. The cost to the economy of the United States is $1.5T annually and growing given the impact of COVID-19. We also discovered there is a shortfall of effective collaboration between nations and a lack of resources in developing countries. Current statistical analyses on the cost of neurological disorders to the world economy strongly suggest that there is a great need for investment in neurotechnology and innovation or fast-tracking therapeutics and diagnostics to curb these costs. During the current COVID-19 pandemic, SBMT, through this paper, intends to showcase the importance of worldwide collaborations to reduce the population's economic and health burden, specifically regarding neurological/brain, spine, and mental disorders.
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Affiliation(s)
- Kevin Morris
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Mohammad Nami
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Iran.,Middle East Brain + Initiative, Los Angeles, CA, USA.,Neuroscience Center, Instituto de Investigaciones Científicas Servicios de Alta Tecnología, City of Knowledge, Panama City, Panama
| | - Joe F Bolanos
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Maria A Lobo
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Melody Sadri-Naini
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - John Fiallos
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Gilberto E Sanchez
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Teshia Bustos
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Nikita Chintam
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Marco Amaya
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Susanne E Strand
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Alero Mayuku-Dore
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Indira Sakibova
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Grace Maria Nicole Biso
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Alejandro DeFilippis
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Daniela Bravo
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Nevzat Tarhan
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Middle East Brain + Initiative, Los Angeles, CA, USA.,Department of Psychiatry, Faculty of Medicine, Uskudar University, Istanbul, Turkey
| | - Carsten Claussen
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Fraunhofer-Institute for Translational Research and Pharmacology, Hamburg, Germany
| | - Alejandro Mercado
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Department of Neurosurgery, Hospital Military Regional Mendoza, Mendoza, Argentina
| | | | - Louis Yuge
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Division of Bio-Environment Adaptation Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.,Cell Therapy Venture Company, Space Bio-Laboratories, Hiroshima, Japan
| | - Shigeo Okabe
- Brain Medical Science Collaboration Division, RIKEN Center for Brain Science Institution and Department: Cellular Neurobiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Konstantin Kotliar
- Department of Biomedical Engineering, Aachen University of Applied Sciences, Aachen, Germany
| | - Christina Sadowsky
- International Center for Spinal Cord Injury, Kennedy Krieger Institute-Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - P Sarat Chandra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | | | - Vasileios Katsaros
- Department of Advanced Imaging Modalities, MRI Unit, General Anti-Cancer and Oncological Hospital of Athens "St. Savvas", Athens, Greece.,Departments of Neurosurgery and Neurology, National and Kapodistrian University of Athens, Athens, Greece.,Department of Neuroradiology, University College of London, London, UK
| | - Brian Mehling
- T-Neuro Pharma, Inc., Albuquerque, NM, USA.,StemVax LLC, Chesterland, OH, USA
| | - Maryam Noroozian
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Cognitive Neurology and Neuropsychiatry Division, Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Abbasioun
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Amirjamshidi
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Department of Neurosurgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholam-Ali Hossein-Zadeh
- Middle East Brain + Initiative, Los Angeles, CA, USA.,National Brain Mapping Laboratory, Tehran, Iran
| | - Faridedin Naraghi
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Iranian Society for Brain Mapping & Therapeutics, Tehran, Iran
| | - Mojtaba Barzegar
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Intelligent Quantitative Bio-Medical Imaging, Tehran, Iran, and Medical Physics Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali A Asadi-Pooya
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Sajad Sahab-Negah
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Neuroscience Research Center, Mashhad University of Medical Sciences, Mashhad Iran.,Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran
| | - Saeid Sadeghian
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Department of Pediatric Neurology, Golestan Medical, Educational, and Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Nesrin Dilbaz
- Department of Psychiatry, Faculty of Medicine, Uskudar University, Istanbul, Turkey
| | - Namath Hussain
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Loma Linda University, School of Medicine, Loma Linda, CA, USA
| | - Zoltan Mari
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
| | - Robert W Thatcher
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Applied Neuroscience Research Institute, St. Petersburg, FL, USA.,Applied Neuroscience, Inc., St. Petersburg, Fl, USA
| | - Daniel Sipple
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA.,Fraunhofer-Institute for Translational Research and Pharmacology, Hamburg, Germany
| | - Kuldip Sidhu
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA.,CK Cell Technologies Pty Ltd, Norwest, NSW, Australia.,Faculty of Medicine, Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia.,Society for Brain Mapping and Therapeutics-Sydney, Sydney, NSW, Australia
| | | | - Francesco Costa
- IRCCS Humanitas Research Hospital, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Ted Berger
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,USC Department of Biomedical Engineering, Los Angeles, CA, USA
| | - Deborah Zelinsky
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,The Mind-Eye Institute, Northbrook, IL, USA
| | - Christopher J Wheeler
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Social Science Research Institute, Tokai University, Shibuya City, Tokyo, Japan
| | - J Wesson Ashford
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Reinhard Schulte
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Loma Linda University, School of Medicine, Loma Linda, CA, USA
| | - M A Nezami
- Sahel Oncology LLC, Newport Beach, CA, USA
| | - Harry Kloor
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Beyond Imagination, Los Angeles, CA, USA
| | - Aaron Filler
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA.,Institute for Nerve Medicine, Santa Monica, CA, USA
| | - Dawn S Eliashiv
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Department of Neurology, UCLA-David Geffen School of Medicine, Los Angeles, CA, USA
| | - Dipen Sinha
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA
| | - Antonio A F DeSalles
- Department of Neurosurgery, UCLA David Geffen School of Medicine, Los Angeles CA, USA.,NeuroSapiens - Rede D'Or São Luiz, Sao Paulo, Brazil.,Society for Brain Mapping and Therapeutics-Brazil, Sao Paulo, Brazil
| | - Venkatraman Sadanand
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Sergey Suchkov
- Applied Neuroscience, Inc., St. Petersburg, Fl, USA.,Society for Brain Mapping and Therapeutics-Russia, Moscow, Russia
| | - Ken Green
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA
| | - Barish Metin
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Department of Psychiatry, Faculty of Medicine, Uskudar University, Istanbul, Turkey
| | - Robert Hariri
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA.,Celularity Corporation, Warren, NJ, USA.,Weill Cornell School of Medicine, Department of Neurosurgery, New York, NY, USA
| | - Jason Cormier
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Blue Horizon International, Hackensack, NJ, USA
| | - Vicky Yamamoto
- Society for Brain Mapping and Therapeutics, Los Angeles, CA, USA.,Brain Mapping Foundation, Los Angeles, CA, USA.,USC Keck School of Medicine, The USC Caruso Department of Otolaryngology-Head and Neck Surgery, Los Angeles, CA, USA.,USC-Norris Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Babak Kateb
- Middle East Brain + Initiative, Los Angeles, CA, USA.,Loma Linda University, School of Medicine, Loma Linda, CA, USA.,National Center for Nanobioelectronics, Los Angeles, CA, USA.,Brain Technology and Innovation Park, Los Angeles, CA, USA
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12
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Zhou R, Zeng Q, Yang H, Xu Y, Tan G, Liu H, Wang L, Zhou H, Zhang M, Feng J, Jin T, Zhang X, Wang J, Zhang X, Gao F, Yang C, Bu B, Li C, Zhang M, Dong H, Lin A, Liu W, Wu L, Wang M, Tang Y, Wang H, Long Y, Wang Z, Zheng W. Status of Immunotherapy Acceptance in Chinese Patients With Multiple Sclerosis: Analysis of Multiple Sclerosis Patient Survival Report 2018. Front Neurol 2021; 12:651511. [PMID: 33897605 PMCID: PMC8060470 DOI: 10.3389/fneur.2021.651511] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/03/2021] [Indexed: 02/05/2023] Open
Abstract
Objective: The prevalence of multiple sclerosis (MS) in China is low, although it has been increasing recently. Owing to the paucity of data on immunotherapy acceptance in the Chinese population, we conducted this study to analyze factors affecting the acceptance of immunotherapy and selection of disease-modifying therapies (DMTs) based on personal and clinical data of patients with MS. Methods: In this study, data were obtained from the Multiple Sclerosis Patient Survival Report 2018, which was the first national survey of patients with MS in China. There were 1,212 patients with MS from 31 provinces who were treated at 49 Chinese hospitals over a 4-month period from May 2018 to August 2018, and the patients were asked to complete online questionnaires to assess their understanding of the disease. Results: In general, highly educated patients with frequent relapses were more willing to receive treatment regardless of DMTs or other immunotherapy, and patients with more understanding of the disease opted to be treated. Younger patient population, patients with severe disease course, and those with more symptoms were likely to choose the treatment. Moreover, a higher proportion of women chose to be treated with DMTs than with other immunotherapies. Conclusions: Education status and patient awareness of the disease impact the treatment acceptance in Chinese patients with MS. Therefore, we call for improving the awareness of MS disease and social security to help patients to improve their quality of life.
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Affiliation(s)
- Ran Zhou
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Qiuming Zeng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Huan Yang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yan Xu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guojun Tan
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Hongbo Liu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lihua Wang
- Department of Neurology, The Second Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Hongyu Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Meini Zhang
- Department of Neurology, The First Affiliated Hospital of Shanxi Medical University, Taiyuan, China
| | - Jinzhou Feng
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tao Jin
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China
| | - Xinghu Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jiawei Wang
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xu Zhang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Feng Gao
- Department of Neurology, Peking University First Hospital, Beijing, China
| | - Chunsheng Yang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Bitao Bu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunyang Li
- Department of Neurology, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Min Zhang
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiqing Dong
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Aiyu Lin
- Department of Neurology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Weibin Liu
- Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lei Wu
- Department of Neurology, General Hospital of the People's Liberation Army, Beijing, China
| | - Manxia Wang
- Department of Neurology, The Second Hospital of Lanzhou University, Lanzhou, China
| | - Yulan Tang
- Department of Neurology, The First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Honghao Wang
- Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Youming Long
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhe Wang
- Department of Neurology, The First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Weihong Zheng
- Department of Neurology, Affiliated Zhongshan Hospital, Xiamen University, Xiamen, China
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13
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Paz-Zulueta M, Parás-Bravo P, Cantarero-Prieto D, Blázquez-Fernández C, Oterino-Durán A. A literature review of cost-of-illness studies on the economic burden of multiple sclerosis. Mult Scler Relat Disord 2020; 43:102162. [DOI: 10.1016/j.msard.2020.102162] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 02/04/2020] [Accepted: 04/26/2020] [Indexed: 11/16/2022]
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14
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Moreno-Navarro P, Gomez-Illán R, Carpena-Juan C, P. Sempere Á, Vera-Garcia FJ, Barbado D. Understanding the Deterioration of Gait, Postural Control, Lower Limb Strength and Perceived Fatigue Across the Disability Spectrum of People with Multiple Sclerosis. J Clin Med 2020; 9:E1385. [PMID: 32397278 PMCID: PMC7290682 DOI: 10.3390/jcm9051385] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 02/07/2023] Open
Abstract
Disability progression is a prominent feature of multiple sclerosis (MS). However, little is known about the extent to which physical condition parameters and perceived fatigue evolve during the disease. We analyzed how strength, balance, core stability and perceived fatigue differ among different cohorts of people with MS (PwMS) with different disability degrees and how these contribute to patients' gait speed and functional mobility. Sixty-three PwMS divided into three groups according to the "Expanded Disability Status Scale" (MS1: EDSS ≤ 1.5; MS2: 2 ≤ EDSS ≤ 3.5; MS3: 4 ≤ EDSS ≤ 6) and 22 healthy controls (HC) participated in this study. MS1 showed lower balance and hip strength compared to HC. MS2 showed lower balance, core stability, gait speed, and functional mobility than MS1. MS3 showed lower gait speed, functional mobility, balance, and knee flexion strength than MS2. No between-group differences were observed in perceived fatigue. Relative weight analysis showed that strength, balance and core stability explained 60%-70% of the variance in gait speed and functional mobility. The decline of each parameter did not evolve at the same rate across the different stages of the disease, being knee flexion strength and balance the most influential factors in the disability progression. Overall, these results provide useful information to guide exercise prescription at different stages of MS.
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Affiliation(s)
- Pedro Moreno-Navarro
- Department of Sports Science, Miguel Hernández University of Elche, 03202 Elche, Spain; (P.M.-N.); (R.G.-I.); (C.C.-J.); (F.J.V.-G.)
| | - Ramón Gomez-Illán
- Department of Sports Science, Miguel Hernández University of Elche, 03202 Elche, Spain; (P.M.-N.); (R.G.-I.); (C.C.-J.); (F.J.V.-G.)
| | - Carmen Carpena-Juan
- Department of Sports Science, Miguel Hernández University of Elche, 03202 Elche, Spain; (P.M.-N.); (R.G.-I.); (C.C.-J.); (F.J.V.-G.)
| | - Ángel P. Sempere
- Department of Clinical Medicine, Miguel Hernández University of Elche, 03550 San Juan de Alicante, Spain;
- Department of Neurology, University General Hospital of Alicante, 03010 Alicante, Spain
| | - Francisco J. Vera-Garcia
- Department of Sports Science, Miguel Hernández University of Elche, 03202 Elche, Spain; (P.M.-N.); (R.G.-I.); (C.C.-J.); (F.J.V.-G.)
| | - David Barbado
- Department of Sports Science, Miguel Hernández University of Elche, 03202 Elche, Spain; (P.M.-N.); (R.G.-I.); (C.C.-J.); (F.J.V.-G.)
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15
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Lasalvia P, Hernández F, Castañeda-Cardona C, Cuestas JA, Rosselli D. Cost-Effectiveness of Natalizumab Compared With Fingolimod for Relapsing-Remitting Multiple Sclerosis Treatment in Colombia. Value Health Reg Issues 2020; 23:13-18. [PMID: 31999987 DOI: 10.1016/j.vhri.2019.08.481] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 07/20/2019] [Accepted: 08/28/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Multiple sclerosis (MS) is a degenerative neurological disorder. Treatment aims to avoid relapses and disability progression. The purpose of this study was to evaluate the cost-effectiveness of natalizumab compared with fingolimod for treating highly active relapsing-remitting MS (RRMS) patients from the Colombian third-party payer perspective. METHODS We used a Markov economic model from the perspective of the Colombian healthcare system to estimate the cost-effectiveness of natalizumab compared with fingolimod for RRMS with high disease activity or failure of interferons as first-line therapy. This model was centered on disability progression and relapses. We considered a 5-year time horizon with a 5% discount rate. We included only direct medical costs. Local experts were consulted to obtain resource utilization estimates, and local standardized costing methodologies and sources were used. Outcome was considered in terms of quality-adjusted life-years (QALYs). Utilities were extracted or calculated from the literature. Transition probabilities were calculated from available efficacy and safety information (1 USD = 3050.98 COP). RESULTS Natalizumab showed lower total costs (USD 80 024 vs USD 98 137) and higher QALY yield (3.01 vs 2.94) than fingolimod, dominating it (incremental cost-effectiveness ratio = -$1861). Univariate sensitivity analysis showcased the relevance of the measures of effect on disability progression for natalizumab on model results. Probabilistic sensitivity analysis replicated base-case results in most simulations. CONCLUSIONS This study showed that natalizumab dominated fingolimod with lower costs and higher QALYs in patients with high-activity RRMS. These results are consistent with previous published international literature.
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Affiliation(s)
- Pieralessandro Lasalvia
- Clinical Epidemiology and Biostatistics Department, Pontificia Universidad Javeriana, Medical School, Bogota, Colombia
| | | | | | | | - Diego Rosselli
- Clinical Epidemiology and Biostatistics Department, Pontificia Universidad Javeriana, Medical School, Bogota, Colombia.
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16
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Poveda JL, Trillo JL, Rubio-Terrés C, Rubio-Rodríguez D, Polanco A, Torres C. Cost-effectiveness of Cladribine Tablets and fingolimod in the treatment of relapsing multiple sclerosis with high disease activity in Spain. Expert Rev Pharmacoecon Outcomes Res 2019; 20:295-303. [PMID: 31220959 DOI: 10.1080/14737167.2019.1635014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To estimate the cost-effectiveness of Cladribine Tablets in the treatment of relapsing multiple sclerosis (RMS) with high disease activity compared with fingolimod, from the perspective of the National Health System (NHS) in Spain. METHODS A Markov model was developed. The annual transition probabilities, were adjusted to patients with RMS with high disease activity. The effect of the treatments compared on the Expanded Disability Status Scale (EDSS) was modeled by hazard ratios for the confirmed progression of disability. The annual relapse rate and the probability of suffering adverse reactions were obtained from a meta-analysis and the literature. The derived costs were calculated from Spanish unit costs. The utilities were obtained from the CLARITY clinical trial and the literature. Deterministic and probabilistic sensitivity analyzes were performed. RESULTS Cladribine tablets was the dominant treatment: lower costs (-86,536 €) and more effective (+1.11 quality-adjusted life years - QALYs) compared to fingolimod. The probability that Cladribine Tablets was cost-effective compared to fingolimod ranged between 94.6% and 96.1% for willingness to pay from € 20,000 to € 30,000 per QALY gained. CONCLUSIONS Cladribine Tablets is a cost-effective treatment, compared to fingolimod, for the treatment of RMS with high disease activity. EXPERT OPINION According to the present study, compared to fingolimod, treatment with Cladribine Tablets of relapsing multiple sclerosis with high disease activity is an option that could generate savings for the Spanish National Health System, with a considerable gain in QALYs. Cladribine Tablets is considered cost-effective and dominant (less costs and more effectiveness) than fingolimod treatment option in this population.
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Affiliation(s)
- J L Poveda
- Pharmacy Department, Hospital Universitario y Politécnico La Fe , Valencia, Spain
| | - J L Trillo
- Pharmacy Department, Hospital Clínico Universitario de Valencia , Valencia, Spain
| | - C Rubio-Terrés
- Pharmacoeconomics Department, Health Value , Madrid, Spain
| | | | - A Polanco
- Corporate Affairs Department, Merck , Madrid, Spain
| | - C Torres
- Corporate Affairs Department, Merck , Madrid, Spain
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17
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García-Domínguez JM, Maurino J, Martínez-Ginés ML, Carmona O, Caminero AB, Medrano N, Ruíz-Beato E. Economic burden of multiple sclerosis in a population with low physical disability. BMC Public Health 2019; 19:609. [PMID: 31109317 PMCID: PMC6528334 DOI: 10.1186/s12889-019-6907-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 04/29/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND In multiple sclerosis (MS), half of affected people are unemployed within 10 years of diagnosis. The aim of this study was to assess the economic impact of MS in adult subjects with relapsing-remitting MS (RRMS) and primary progressive MS (PPMS). METHODS A multicenter, non-interventional, cross-sectional study was conducted. The Expanded Disability Status Scale (EDSS) and the 23-item Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ-23) were used to assess disability and work performance, respectively. Only indirect costs were considered using the human capital method, including work costs. Professional support costs and informal caregivers' costs were also estimated. RESULTS A total of 199 subjects were studied (mean age: 43.9 ± 10.5 years, 60.8% female, 86.4% with RRMS). Median EDSS score was 2.0 (interquartile range: 1.0-3.5) and median MSWDQ-23 total score was 31.5 (15.2, 50.0). The number of employed subjects decreased after MS diagnosis from 70.6 to 47.2%, and the number of retired people increased (23.6%). Mean age of retirement was 43.6 ± 10.5 years. Ten percent of the population had sick leaves (absenteeism was seen in 90.9% of the student population and 30.9% of the employed population). Professional support in their daily life activities was needed in 28.1% of subjects. Costs for sick leave, work absenteeism, premature retirement and premature work disability/pensioner were €416.6 ± 2030.2, €763.4 ± 3161.8, €5810.1 ± 13,159.0 and €1816.8 ± 9630.7, respectively. Costs for professional support and informal caregiving activities were €1026.93 ± 4622.0 and €1328.72, respectively. CONCLUSIONS MS is responsible for a substantial economic burden due to indirect and informal care costs, even in a population with low physical disability.
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Affiliation(s)
| | - Jorge Maurino
- Medical Department, Roche Farma, Ribera del Loira, 50, 28042, Madrid, Spain.
| | | | - Olga Carmona
- Department of Neurology, Hospital de Figueres, Figueres, Spain
| | - Ana B Caminero
- Department of Neurology, Hospital Nuestra Señora de Sonsoles, Complejo Asistencial de Ávila, Ávila, Spain
| | - Nicolás Medrano
- Medical Department, Roche Farma, Ribera del Loira, 50, 28042, Madrid, Spain
| | - Elena Ruíz-Beato
- Health Economics and Outcomes Research Unit, Roche Farma, Madrid, Spain
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Sicras-Mainar A, Ruíz-Beato E, Navarro-Artieda R, Maurino J. Impact on healthcare resource utilization of multiple sclerosis in Spain. BMC Health Serv Res 2017; 17:854. [PMID: 29284493 PMCID: PMC5747126 DOI: 10.1186/s12913-017-2807-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 12/15/2017] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is a chronic disease with a high socioeconomic impact. The aim of this study was to assess healthcare resources utilization and costs in a sample of patients with MS. METHODS A retrospective, cohort study was conducted using electronic medical records from 19 primary care centres in Asturias and Catalonia, Spain. Adult patients diagnosed with MS were distributed into two groups according to the Expanded Disability Status Scale (EDSS) score: 0-3.5 (no-moderate disability) and 4-9.5 (severe disability). Healthcare (direct cost) and non-healthcare costs (work productivity losses) were analysed. An analysis of covariance (ANCOVA) was used for correction, p < 0.05. A multiple regression model was performed to obtain the variables associated with costs. RESULTS A total of 222 patients were analyzed; mean (SD) age: 45.5 (12.5) years, 64.4% female, and 62.2% presented a diagnosis of relapsing-remitting MS. Median EDSS score was 2.5, with 68.5% of the patients with no to moderate disability. The mean annual cost per MS patient was €25,103. For no-moderate and severe disability, the ANCOVA-adjusted mean annual cost was €23,157 and €29,242, respectively (p = 0.013). Direct costs and MS disease-modifying therapy accounted for 39.4% and 31.7% of the total costs, respectively. The total costs were associated with number of relapses (β = 0.135, p = 0.001), time since diagnosis (β = 0.281, p = 0.023), and age (β = 0.198, p = 0.037). CONCLUSIONS Multiple sclerosis imposes a substantial economic burden on the Spanish National Health System, patients and society as a whole. Costs significantly correlated with disease progression.
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Affiliation(s)
- Antoni Sicras-Mainar
- Fundación Rediss (Red de Investigación en Servicios Sanitarios), Barcelona, Spain
| | - Elena Ruíz-Beato
- Health Economics and Outcomes Research Unit, Roche Farma, Madrid, Spain
| | - Ruth Navarro-Artieda
- Department of Medical Information, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Jorge Maurino
- Medical Department, Roche Farma, Madrid, Spain. .,, Madrid, Spain.
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