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Rodríguez-Santana I, Mestre T, Squitieri F, Willock R, Arnesen A, Clarke A, D'Alessio B, Fisher A, Fuller R, Hamilton JL, Hubberstey H, Stanley C, Vetter L, Winkelmann M, Doherty M, Wu Y, Finnegan A, Frank S. Economic burden of Huntington disease in Europe and the USA: Results from the Huntington's Disease Burden of Illness study. Eur J Neurol 2023; 30:1109-1117. [PMID: 36421029 DOI: 10.1111/ene.15645] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE The prevalence of Huntington disease (HD) has increased over time; however, there is a lack of up-to-date evidence documenting the economic burden of HD by disease stage. This study provides an estimate of the annual direct medical, nonmedical, and indirect costs associated with HD from participants in the Huntington's Disease Burden of Illness (HDBOI) study in five European countries and the USA. METHODS The HDBOI is a retrospective, cross-sectional study. Data collection was conducted between September 2020 and May 2021. Participants were recruited by their HD-treating physicians and categorized as early stage (ES), mid stage (MS), or advanced stage (AS) HD. Data were collected via three questionnaires: a case report form, completed by physicians who collected health care resource use associated with HD to compute direct medical cost, and optional patient and caregiver questionnaires, which included information used to compute nondirect medical and indirect costs. Country-specific unit cost sources were used. RESULTS HDBOI cost estimates were €12,663 (n = 2094) for direct medical costs, €2984 (n = 359) for nondirect medical costs, and €47,576 (n = 436) for indirect costs. Costs are higher in patients who are at later stages of disease; for example, direct medical costs estimates were €9220 (n = 846), €11,885 (n = 701), and €18,985 (n = 547) for ES, MS, and AS, respectively. Similar trends were observed for nondirect and indirect costs. Costs show large variations between patients and countries. CONCLUSIONS Cost estimates from the HDBOI study show that people with HD and their caregivers bear a large economic burden that increases as disease progresses.
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Affiliation(s)
| | - Tiago Mestre
- Ottawa Hospital Research Institute, Ontario, Ottawa, Canada
| | - Ferdinando Squitieri
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Casa Sollievo della Sofferenza Research Hospital, San Giovanni Rotondo, Italy
| | | | - Astri Arnesen
- European Huntington Association, Kristiansand, Norway
| | - Alison Clarke
- Manchester Centre for Genomic Medicine, Manchester, UK
| | | | - Alex Fisher
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - Rebecca Fuller
- CHDI Management/CHDI Foundation, New York, New York, USA
| | | | | | | | - Louise Vetter
- Huntington's Disease Society of America, New York, New York, USA
| | | | | | | | - Alan Finnegan
- The Faculty of Health and Social Care, University of Chester, Cheshire, UK
| | - Samuel Frank
- Harvard Medical School/Beth Israel Deaconess Medical Center, Massachusetts, Boston, USA
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Sun SX, Lowndes S, Willock R, Jones C, Brighton S. Outcomes in Patients With von Willebrand Disease Receiving Recombinant von Willebrand Factor on Demand and in Surgical Settings: Chart Review. Clin Appl Thromb Hemost 2023; 29:10760296231177294. [PMID: 37282513 DOI: 10.1177/10760296231177294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
This European observational chart review assessed the efficacy/safety of recombinant von Willebrand factor (rVWF) for on-demand treatment of spontaneous/traumatic bleeds and prevention and/or treatment of surgery-related bleeding in adults with von Willebrand disease (VWD). Patients (n = 91) were enrolled at first rVWF administration (index). Data were collected for the 12 months before index and until death, loss to follow-up, or end of study (3-12 months after index). Fifteen patients reported an rVWF-treated spontaneous/traumatic bleed at index. Bleed resolution was obtained for 14 patients (unknown status, n = 1), and investigators assessed treatment satisfaction for 13 rVWF prescriptions (2 moderate, 5 good, and 6 excellent). rVWF was used to prevent/treat surgery-related bleeds at index in 76 patients. Bleed resolution was achieved in 25/58 rVWF-treated surgeries; bleed resolution was not applicable for 33 surgeries. In both groups, there were no reports of treatment-emergent adverse events after initiating rVWF, including hypersensitivity reactions, thrombotic events, and VWF inhibitor development. rVWF was shown to be effective for the on-demand treatment of spontaneous/traumatic bleeds, and for the prevention and treatment of surgical bleeds in this real-world VWD population.
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Affiliation(s)
- Shawn X Sun
- Takeda Development Center Americas, Inc., Cambridge, MA, USA
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Willock R, Rickards H, Rosser AE, Haw A, Stanley C, Hossain P, Rodríguez-Santana I, Doherty M, Blair R, Kane W. An Overview of Specialist Services for Huntington's Disease in the United Kingdom. J Huntingtons Dis 2023; 12:363-370. [PMID: 38108355 DOI: 10.3233/jhd-230560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
BACKGROUND Huntington's disease (HD) is a rare inherited neurodegenerative disorder characterized by complex evolving needs that change as the condition progresses. There is limited understanding about the organization of HD clinical services and their resourcing in the United Kingdom (UK). OBJECTIVE To understand the organization and resourcing of specialist HD services for people with HD (PwHD) in the UKMethods:This cross-sectional study collected quantitative data via on online survey, and qualitative data via telephone semi-structured interviews. Descriptive statistics were used to describe quantitative outcomes, and qualitative results were analyzed using content analysis. RESULTS A total of 31 specialist services for HD were identified. Of the 27 services that completed the online survey, 23 had an active multidisciplinary team of healthcare professionals (HCPs) and were led primarily by a mental health trust (26%) or tertiary referral hospital (26%). Specialist services offered outpatient clinics (96%), outreach in the community (74%), telemedicine (70%), inpatient beds (26%) and satellite clinics (26%). Many services indicated that their capacity (ability to see patients as often as needed with current resources) was difficult, with some services reporting more difficulty at the early or later stages of HD. Key resourcing gaps were identified with access to facilities, HCPs and referral networks. CONCLUSIONS This research highlights the variation in organization and capacity within individual HD services as well as current resourcing and gaps in access that influence this capacity. Further research should be done to understand the impact of service organization and current resourcing gaps in access on the quality of care provided for PwHD in the UK.
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Affiliation(s)
| | - Hugh Rickards
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, England, UK
| | - Anne E Rosser
- Schools of Medicine and Biosciences, Cardiff University, Cardiff, Wales, UK
| | - Alistair Haw
- Scottish Huntington's Association, Paisley, Scotland, UK
| | - Cath Stanley
- Huntington's Disease Association, Liverpool, England, UK
| | | | | | | | - Rachel Blair
- Roche Products Ltd., Welwyn Garden City, England, UK
| | - Wendy Kane
- Roche Products Ltd., Welwyn Garden City, England, UK
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Willock R, Rickards H, Rosser AE, Haw A, Stanley C, Hossain P, Rodríguez-Santana I, Doherty M, Blair R, Kane W. An Overview of Specialist Services for Huntington's Disease in the United Kingdom. J Huntingtons Dis 2023; 12:363-370. [PMID: 38108355 PMCID: PMC10741324 DOI: 10.3233/jhd-220560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND Huntington's disease (HD) is a rare inherited neurodegenerative disorder characterized by complex evolving needs that change as the condition progresses. There is limited understanding about the organization of HD clinical services and their resourcing in the United Kingdom (UK). OBJECTIVE To understand the organization and resourcing of specialist HD services for people with HD (PwHD) in the UKMethods:This cross-sectional study collected quantitative data via on online survey, and qualitative data via telephone semi-structured interviews. Descriptive statistics were used to describe quantitative outcomes, and qualitative results were analyzed using content analysis. RESULTS A total of 31 specialist services for HD were identified. Of the 27 services that completed the online survey, 23 had an active multidisciplinary team of healthcare professionals (HCPs) and were led primarily by a mental health trust (26%) or tertiary referral hospital (26%). Specialist services offered outpatient clinics (96%), outreach in the community (74%), telemedicine (70%), inpatient beds (26%) and satellite clinics (26%). Many services indicated that their capacity (ability to see patients as often as needed with current resources) was difficult, with some services reporting more difficulty at the early or later stages of HD. Key resourcing gaps were identified with access to facilities, HCPs and referral networks. CONCLUSIONS This research highlights the variation in organization and capacity within individual HD services as well as current resourcing and gaps in access that influence this capacity. Further research should be done to understand the impact of service organization and current resourcing gaps in access on the quality of care provided for PwHD in the UK.
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Affiliation(s)
| | - Hugh Rickards
- Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, England, UK
| | - Anne E. Rosser
- Schools of Medicine and Biosciences, Cardiff University, Cardiff, Wales, UK
| | - Alistair Haw
- Scottish Huntington’s Association, Paisley, Scotland, UK
| | - Cath Stanley
- Huntington’s Disease Association, Liverpool, England, UK
| | | | | | | | - Rachel Blair
- Roche Products Ltd., Welwyn Garden City, England, UK
| | - Wendy Kane
- Roche Products Ltd., Welwyn Garden City, England, UK
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Santana IR, Frank S, Doherty M, Willock R, Hamilton J, Hubberstey H, Stanley C, Vetter L, Winkelmann M, Dolmetsch RE, Li N, Ratsch S, Ali TM. Humanistic Burden of Huntington Disease: Evidence From the Huntington Disease Burden of Illness Study. Neurol Clin Pract 2022; 12:e172-e180. [DOI: 10.1212/cpj.0000000000200095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 09/13/2022] [Indexed: 11/15/2022]
Abstract
ABSTRACT [346/ 350 words]Background and Objectives:Huntington’s Disease (HD) is a rare, inherited and highly complex neuro-degenerative disorder with no currently approved disease modifying treatments. We investigated the impact of HD on health-related quality of life (HRQoL) and other patient-reported outcomes in the Huntington’s Disease Burden of Illness (HDBOI) study.Methods:The HDBOI study is a retrospective, cross-sectional study conducted between September 2020 and May 2021 in France, Germany, Italy, Spain, the United Kingdom and the United States. People with symptomatic onset HD (PwHD) were recruited by their HD-treating physicians and categorized as early (ES), mid (MS) or advanced stage (AS) HD. Physicians provided sociodemographic and clinical information from the participant’s medical records in electronic case report forms (eCRF); participants or their proxies completed online Patient Public Involvement Engagement questionnaires (PPIE-P). Patient-reported outcomes included the EQ-5D-5L, SF-36 v2 (and SF-6D utility), Huntington Quality of Life Instrument (H-QoL-I), and the Work Productivity and Activity Impairment Specific Health Problem (WPAI-SHP). All outcomes were summarized using descriptive statistics, differences between disease stages were assessed by Kruskal-Wallis tests.Results:A total of 2,094 PwHD were enrolled with completed eCRFs (100%) and PPIE-P forms (n=482, 23%). Participants mean age was 47.3 years, they were generally evenly distributed across countries, with the majority being ES (40%) followed by MS (33%) and LS (26%). Mean EQ-5D-5L (n=336) utility scores was 0.59 (SD, 0.27), with the highest mean utility scores [SD] in ES (0.72 [0.22]) followed by MS (0.62 [0.18]) and AS (0.37 [0.30]), p<0.001. Mean SF-6D score (n=482) was 0.57 (SD, 0.10), with mean values decreasing with advanced disease (ES, 0.61; MS, 0.56; AS, 0.50, p<0.001). H-QoL-I mean scores (n=482) also worsened with more advanced disease, from 0.58 for ES to 0.49 for MS and 0.37 for AS, p<0.001. Impairment in daily activities and in work productivity. Overall proxy-respondents reported on average worse outcomes than PwHD (self-reported) across all outcomes and disease stages suggesting a possible unawareness of deficits by PwHD.Conclusion:The HDBOI study provides new insights into the characteristics and humanistic burden of PwHD, and offers a meaningful contribution to this underserved research area.
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Gruselle P, Mainguet P, Haot J, Willock R, Dive C. [Endoscopic study of gastric lymphomas (author's transl)]. Acta Gastroenterol Belg 1976; 39:358-65. [PMID: 1007821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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