Contributions
Abstract: P396
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Economic burden
Introduction: National healthcare systems are confronted by soaring costs for disease-modifying treatments (DMTs) in multiple sclerosis (MS). We aim to assess whether the introduction of new diagnostic criteria is associated with higher costs for treating MS, as a consequence of early diagnosis and increased number of people with MS eligible to DMTs.
Methods: The present cohort study retrospectively included 2229 RRMS patients (42.1±11.2 years; female 63.3%), followed up from 1997 to 2017 (mean follow-up 8.5±4.7 years). Costs for DMT administration and management were calculated, and referred to each year of observation (annual costs). An interrupted time-series analysis was employed to assess whether the introduction of new diagnostic criteria (2001, 2006, and 2011) had an impact in modifying the average annual patient cost for treatment. The DMT cost variable was log-transformed to reduce data skewness. To account for repeated measurements within each patient over the study period, a mixed-effect log-linear regression model was employed, with the covariates age, gender, disease duration, DMT type, year of treatment start and baseline EDSS included as fixed effects in the model. Interaction terms between time and inclusion of new diagnostic criteria were also included.
Results: Average annual cost per patient was 12356.50±6198.45 euros. We observed a 0.6% increase in the average annual cost per patient after the introduction of 2001 criteria (Coeff=0.006; 95%CI=0.003/0.009; p>0.001), no significant variations after 2006 criteria, and a 0.3% decrease after 2010 criteria (Coeff=-0.003; 95%CI=-0.006/-0.001; p=0.045). When we did not adjust for DMT type, average annual cost per patient increased by 7.9% after 2010 criteria (Coeff=0.079; 95%CI=0.059-0.099; p< 0.001).
Discussion: In RRMS, average annual costs per patient are mainly driven by the introduction of more effective and expensive DMTs in recent years. Costs have otherwise remained stable over time independently from the introduction of new criteria. Profiling RRMS patients towards the most appropriate treatment is needed to control DMT-related costs.
Disclosure: Martina Petruzzo: nothing to disclose.
Raffaele Palladino: nothing to disclose.
Antonio Nardone: nothing to disclose.
Agostino Nozzolillo: nothing to disclose.
Giuseppe Servillo: nothing to disclose.
Alessandro Roggeri: nothing to disclose.
Daniela Roggeri: nothing to disclose.
Marcello De Angelis: nothing to disclose.
Roberta Lanzillo has received honoraria from Sanofi-Genzyme, Teva, Biogen, Novartis, Almirall, Merk Serono.
Maria Triassi: nothing to disclose.
Vincenzo Brescia Morra has received honoraria from Sanofi-Genzyme, Teva, Biogen, Novartis, Almirall, Merk Serono.
Marcello Moccia has received research grants from MAGNIMS-ECTRIMS and Merck.
Abstract: P396
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Economic burden
Introduction: National healthcare systems are confronted by soaring costs for disease-modifying treatments (DMTs) in multiple sclerosis (MS). We aim to assess whether the introduction of new diagnostic criteria is associated with higher costs for treating MS, as a consequence of early diagnosis and increased number of people with MS eligible to DMTs.
Methods: The present cohort study retrospectively included 2229 RRMS patients (42.1±11.2 years; female 63.3%), followed up from 1997 to 2017 (mean follow-up 8.5±4.7 years). Costs for DMT administration and management were calculated, and referred to each year of observation (annual costs). An interrupted time-series analysis was employed to assess whether the introduction of new diagnostic criteria (2001, 2006, and 2011) had an impact in modifying the average annual patient cost for treatment. The DMT cost variable was log-transformed to reduce data skewness. To account for repeated measurements within each patient over the study period, a mixed-effect log-linear regression model was employed, with the covariates age, gender, disease duration, DMT type, year of treatment start and baseline EDSS included as fixed effects in the model. Interaction terms between time and inclusion of new diagnostic criteria were also included.
Results: Average annual cost per patient was 12356.50±6198.45 euros. We observed a 0.6% increase in the average annual cost per patient after the introduction of 2001 criteria (Coeff=0.006; 95%CI=0.003/0.009; p>0.001), no significant variations after 2006 criteria, and a 0.3% decrease after 2010 criteria (Coeff=-0.003; 95%CI=-0.006/-0.001; p=0.045). When we did not adjust for DMT type, average annual cost per patient increased by 7.9% after 2010 criteria (Coeff=0.079; 95%CI=0.059-0.099; p< 0.001).
Discussion: In RRMS, average annual costs per patient are mainly driven by the introduction of more effective and expensive DMTs in recent years. Costs have otherwise remained stable over time independently from the introduction of new criteria. Profiling RRMS patients towards the most appropriate treatment is needed to control DMT-related costs.
Disclosure: Martina Petruzzo: nothing to disclose.
Raffaele Palladino: nothing to disclose.
Antonio Nardone: nothing to disclose.
Agostino Nozzolillo: nothing to disclose.
Giuseppe Servillo: nothing to disclose.
Alessandro Roggeri: nothing to disclose.
Daniela Roggeri: nothing to disclose.
Marcello De Angelis: nothing to disclose.
Roberta Lanzillo has received honoraria from Sanofi-Genzyme, Teva, Biogen, Novartis, Almirall, Merk Serono.
Maria Triassi: nothing to disclose.
Vincenzo Brescia Morra has received honoraria from Sanofi-Genzyme, Teva, Biogen, Novartis, Almirall, Merk Serono.
Marcello Moccia has received research grants from MAGNIMS-ECTRIMS and Merck.