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Heinrich F, Cordts I, Günther R, Stolte B, Zeller D, Schröter C, Weyen U, Regensburger M, Wolf J, Schneider I, Hermann A, Metelmann M, Kohl Z, Linker RA, Koch JC, Radelfahr F, Schönfelder E, Gardt P, Mohajer-Peseschkian T, Osmanovic A, Klopstock T, Dorst J, Ludolph AC, Schöffski O, Boentert M, Hagenacker T, Deschauer M, Lingor P, Petri S, Schreiber-Katz O. Economic evaluation of Motor Neuron Diseases: a nationwide cross-sectional analysis in Germany. J Neurol 2023; 270:4922-4938. [PMID: 37356024 PMCID: PMC10511618 DOI: 10.1007/s00415-023-11811-1] [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] [Received: 03/19/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND AND OBJECTIVES Motor Neuron Diseases (MND) are rare diseases but have a high impact on affected individuals and society. This study aims to perform an economic evaluation of MND in Germany. METHODS Primary patient-reported data were collected including individual impairment, the use of medical and non-medical resources, and self-rated Health-Related Quality of Life (HRQoL). Annual socio-economic costs per year as well as Quality-Adjusted Life Years (QALYs) were calculated. RESULTS 404 patients with a diagnosis of Amyotrophic Lateral Sclerosis (ALS), Spinal Muscular Atrophy (SMA) or Hereditary Spastic Paraplegia (HSP) were enrolled. Total annual costs per patient were estimated at 83,060€ in ALS, 206,856€ in SMA and 27,074€ in HSP. The main cost drivers were informal care (all MND) and disease-modifying treatments (SMA). Self-reported HRQoL was best in patients with HSP (mean EuroQoL Five Dimension Five Level (EQ-5D-5L) index value 0.67) and lowest in SMA patients (mean EQ-5D-5L index value 0.39). QALYs for patients with ALS were estimated to be 1.89 QALYs, 23.08 for patients with HSP and 14.97 for patients with SMA, respectively. Cost-utilities were estimated as follows: 138,960€/QALY for ALS, 525,033€/QALY for SMA, and 49,573€/QALY for HSP. The main predictors of the high cost of illness and low HRQoL were disease progression and loss of individual autonomy. CONCLUSION As loss of individual autonomy was the main cost predictor, therapeutic and supportive measures to maintain this autonomy may contribute to reducing high personal burden and also long-term costs, e.g., care dependency and absenteeism from work.
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Affiliation(s)
- Felix Heinrich
- Department of Neurology, Hannover Medical School, Carl-Neuberg Straße 1, 30625 Hannover, Germany
| | - Isabell Cordts
- Department of Neurology, Klinikum Rechts Der Isar, Technical University of Munich, 81675 Munich, Germany
| | - René Günther
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
- German Center for Neurodegenerative Diseases (DZNE), 01307 Dresden, Germany
| | - Benjamin Stolte
- Department of Neurology, University Medicine Essen, 45147 Essen, Germany
| | - Daniel Zeller
- Department of Neurology, University of Würzburg, 97080 Würzburg, Germany
| | - Carsten Schröter
- Hoher Meißner Clinic, Neurology, 37242 Bad Sooden-Allendorf, Germany
| | - Ute Weyen
- Department of Neurology, Ruhr-University Bochum, BG-Kliniken Bergmannsheil, 44789 Bochum, Germany
| | - Martin Regensburger
- Department of Molecular Neurology, Friedrich-Alexander-University Erlangen-Nürnberg, 91054 Erlangen, Germany
- Center for Rare Diseases Erlangen (ZSEER), University Hospital Erlangen, 91054 Erlangen, Germany
| | - Joachim Wolf
- Department of Neurology, Diakonissen Hospital Mannheim, 68163 Mannheim, Germany
| | - Ilka Schneider
- Department of Neurology, Martin-Luther University Halle/Saale, 06120 Halle, Germany
- Department of Neurology, Klinikum Sankt Georg, 04129 Leipzig, Germany
| | - Andreas Hermann
- Translational Neurodegeneration Section “Albrecht-Kossel”, Department of Neurology, University Medical Center Rostock, University of Rostock, 18147 Rostock, Germany
- German Center for Neurodegenerative Diseases Rostock/Greifswald, 18147 Rostock, Germany
| | - Moritz Metelmann
- Department of Neurology, University Hospital Leipzig, 04103 Leipzig, Germany
| | - Zacharias Kohl
- Department of Neurology, University of Regensburg, 93053 Regensburg, Germany
| | - Ralf A. Linker
- Department of Neurology, University of Regensburg, 93053 Regensburg, Germany
| | - Jan Christoph Koch
- Department of Neurology, University Medicine Göttingen, 37075 Göttingen, Germany
| | - Florentine Radelfahr
- Friedrich-Baur-Institute, Department of Neurology, University Hospital, Ludwig Maximilian University of Munich, 80336 Munich, Germany
| | - Erik Schönfelder
- Department of Neurology, Hannover Medical School, Carl-Neuberg Straße 1, 30625 Hannover, Germany
| | - Pavel Gardt
- Department of Neurology, Hannover Medical School, Carl-Neuberg Straße 1, 30625 Hannover, Germany
| | - Tara Mohajer-Peseschkian
- Department of Neurology, Hannover Medical School, Carl-Neuberg Straße 1, 30625 Hannover, Germany
| | - Alma Osmanovic
- Department of Neurology, Hannover Medical School, Carl-Neuberg Straße 1, 30625 Hannover, Germany
- Essener Zentrum Für Seltene Erkrankungen (EZSE), Universitätsmedizin Essen, University Hospital Essen, Essen, Germany
| | - Thomas Klopstock
- Friedrich-Baur-Institute, Department of Neurology, University Hospital, Ludwig Maximilian University of Munich, 80336 Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), 80336 Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), 80336 Munich, Germany
| | - Johannes Dorst
- Department of Neurology, University of Ulm, 89081 Ulm, Germany
- German Center for Neurodegenerative Diseases (DZNE), 89081 Ulm, Germany
| | - Albert C. Ludolph
- Department of Neurology, University of Ulm, 89081 Ulm, Germany
- German Center for Neurodegenerative Diseases (DZNE), 89081 Ulm, Germany
| | - Oliver Schöffski
- Chair of Health Management, School of Business, Economics and Society, Friedrich-Alexander University (FAU) Erlangen-Nürnberg, 90403 Nuremberg, Germany
| | - Matthias Boentert
- Department of Neurology with the Institute of Translational Neurology, University Hospital Münster, 48149 Münster, Germany
- Department of Medicine, UKM Marienhospital, 48565 Steinfurt, Germany
| | - Tim Hagenacker
- Department of Neurology, University Medicine Essen, 45147 Essen, Germany
| | - Marcus Deschauer
- Department of Neurology, Klinikum Rechts Der Isar, Technical University of Munich, 81675 Munich, Germany
| | - Paul Lingor
- Department of Neurology, Klinikum Rechts Der Isar, Technical University of Munich, 81675 Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), 80336 Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), 80336 Munich, Germany
| | - Susanne Petri
- Department of Neurology, Hannover Medical School, Carl-Neuberg Straße 1, 30625 Hannover, Germany
| | - Olivia Schreiber-Katz
- Department of Neurology, Hannover Medical School, Carl-Neuberg Straße 1, 30625 Hannover, Germany
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Liampas I, Siokas V, Aloizou AM, Bakirtzis C, Tsouris Z, Nousia A, Nasios G, Papadimitriou D, Liakos P, Bogdanos DP, Hadjigeorgiou GM, Dardiotis E. MOBP rs616147 Polymorphism and Risk of Amyotrophic Lateral Sclerosis in a Greek Population: A Case-Control Study. Medicina (Kaunas) 2021; 57:1337. [PMID: 34946282 DOI: 10.3390/medicina57121337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 02/05/2023]
Abstract
Background and Objectives: To date, only one study has investigated the association between the rs616147 polymorphism of the Myelin-associated Oligodendrocyte Basic Protein (MOBP) locus and Amyotrophic Lateral Sclerosis (ALS). Materials and Methods: A case-control study was performed. Patients with definite sporadic ALS were prospectively and consecutively recruited from the inpatient and outpatient clinics of the Neurology Department of the General University Hospital of Larissa, Central Greece. Community based, age and sex matched healthy individuals with a free personal and family history constituted the control group. Results: A total of 155 patients with definite sporadic ALS and an equal number of healthy controls were genotyped. The power of our sample size was slightly above 80% and MOBP rs616147 was determined to be in Hardy-Weinberg Equilibrium among healthy participants (p = 1.00). According to the univariate analysis, there was no significant relationship between rs616147 and ALS [log-additive OR = 0.85 (0.61, 1.19), over-dominant OR = 0.73 (0.46, 1.15), recessive OR = 1.02 (0.50, 2.09), dominant OR = 0.74 (0.47, 1.16), co-dominant OR1 = 0.71 (0.44, 1.14) and co-dominant OR2 = 0.88 (0.42, 1.84). Additionally, the effect of rs616147 on the age of ALS onset was determined insignificant using both unadjusted and adjusted (sex, site of onset) cox-proportional models. Finally, rs616147 was not related to the site of ALS onset. Conclusions: Our study is the first to report the absence of an association between MOBP rs616147 and ALS among individuals of Greek ancestry. Additional, larger nationwide and multi-ethnic studies are warranted to shed light on the connection between rs616147 and ALS.
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Makizodila BAM, van de Wijdeven JHE, de Soet JJ, van Selms MKA, Volgenant CMC. Oral hygiene in patients with motor neuron disease requires attention: A cross-sectional survey study. Spec Care Dentist 2021; 42:9-14. [PMID: 34310733 PMCID: PMC9291847 DOI: 10.1111/scd.12636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 07/09/2021] [Indexed: 11/27/2022]
Abstract
Aims Motor Neuron Disease (MND) is a progressive neurodegenerative neuromuscular disease, which can progressively impair arm‐hand function. Needs and barriers of MND patients and their caregivers in performing oral hygiene were studied. Methods An online survey was sent to 706 MND patients. The questions of the survey included self‐reliance, self‐reported oral health, and oral hygiene. The oral health‐related quality of life (GOHAI‐NL) and the subjective well‐being (ALSAQ‐5) were also measured. Results A total of 259 patients responded (36.7%), of which 71.9% stated not to be informed about the importance of maintaining good oral health by their MND treatment team. Moreover, 40.4% would like to receive help concerning oral hygiene from a dental professional. 19.8% were not satisfied about oral care as conducted by themselves or their caregivers. Patients who do not ask for support with their daily oral care had a significantly worse oral health‐related quality of life compared to patients who do ask for support. Conclusions The support for daily oral hygiene of MND patients and their barriers to requesting support needs more attention from both MND‐treatment teams and general dental professionals.
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Affiliation(s)
- Berthe A M Makizodila
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Center for Special Dental Care (SBT), Amsterdam, The Netherlands
| | - Johanna H E van de Wijdeven
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Vogellanden, Center for Special Dental Care, Zwolle, The Netherlands
| | - Johannes J de Soet
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maurits K A van Selms
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Catherine M C Volgenant
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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