MG tied to high personal, societal economic burden in German study
Analysis of patient surveys, claims data highlights 'expensive' treatments
Myasthenia gravis (MG) is associated with a high personal and societal economic burden, due to work engagement and income difficulties, physician visits, hospitalizations, and medications.
That’s according to a new study from Germany that analyzed responses from patient surveys on personal burden, as well as data from a claims dataset of healthcare costs. That data also demonstrated that the burden is higher for patients on intensified treatment.
“MG represents a major economic burden for the individual and the health care system,” the researchers wrote, noting both that “costs are positively associated with the severity of disease” and that “the economic burden is particularly high for working patients.”
Noting that MG “often requires lifelong treatment,” the team called for future studies, particularly as new treatments are developed.
“As expensive novel therapeutic options emerge, investigations into this domain are poised to become increasingly imperative in the coming years,” the researchers wrote. “Further studies would not only facilitate better resource allocation within healthcare systems but also inform policy measures aimed at alleviating the financial strain on both individuals and societies.”
The study, “The economic burden of Myasthenia gravis from the patient´s perspective and reflected in German claims data,” was published in the journal Scientific Reports. Financial support was provided by UCB Pharma for a subanalysis, but the company was not involved in the study’s design, the researchers noted.
Investigating the overall economic burden of MG in Germany
MG is caused by self-reactive antibodies that target proteins important for the communication between nerve and muscle cells. The disease is marked by symptoms of muscle weakness and fatigue, which may come and go.
The researchers noted that immunosuppressive therapies can help to keep patients’ symptoms under control, but also highlighted the “costly” treatments used in emergency situations.
“The financial aspect of managing MG is becoming increasingly relevant with emerging novel therapies both adding value to standard of care and costs to the healthcare system,” the researchers wrote, adding that “the precise treatment costs associated with MG remain inadequately understood.”
To learn more about the overall economic burden of MG, the team analyzed data from two sources: a questionnaire-based survey on MG patients registered in the German Myasthenia Society (DMG), collected in 2019, and a claims dataset provided by a German health insurance company covering the period spanning 2014 to 2019.
The DMG Mya-BoD (NCT03979521) dataset comprised 1,660 patients, slightly more than half of whom (56%) were women. The mean age of the patients was 65.2, and they had a mean disease duration of 13.6 years. Most patients (77%) had generalized MG and about half had late-onset disease — when the first MG symptoms appear at the age of 50 or older.
About three-quarters of patients received standard treatment while 10% were given intensified treatment. A total of 13% had received no MG-related treatment.
Standard treatment involved corticosteroids, pyridostigmine (sold as Mestinon and generics), and immunosuppressants. Intensified treatment, meanwhile, was marked by the use of Soliris (eculizumab), rituximab, intravenous immunoglobulin, or IVIG, and plasma exchange.
The claims dataset comprised a total of 775 patients, primarily with late-onset disease (84.5%). Thes patients had a mean age of 66.9 at the time of diagnosis. As in the DMG dataset, slightly more than of these patients (58%) were on standard treatment, while 13% were on intensified treatment, and nearly 30% received no treatment.
MG-related absences common in first year for working patients
Overall, in the DMG dataset, MG caused disability in 19% of working patients. Also, 29% of the patients experienced income losses due to MG, and one-quarter reported their state of living was less favorable since they had been diagnosed with MG. About 80% of the patients reported to have self-funded costs related to the disease, particularly those on intensified treatment.
Among working patients in the claims dataset, nearly 60% had at least one MG-related work absence in the first year, which was associated with treatment intensity.
Regarding healthcare resource utilization, patients in the DMG dataset had a mean of 5.2 appointments per year, similar to MG-related outpatient visits reported in the claims dataset in the first year (4.9 visits per patient-year).
A mean of 0.9 hospital stays was observed in the DMG dataset (0.8 per patient-year in the claims dataset) within the prior year, with a mean of 0.2 emergency room visits (0.36 per patient-year in the claims dataset). Those on intensified treatment had more doctor visits, more and longer hospitalizations, and more emergency room visits.
We have demonstrated that the burden of [MG] encompasses an economic dimension. … Specifically, persons affected by MG experience limitations in occupational engagement and income, while society faces significant financial burdens, particularly in cases of [patients who are] young, working, individuals and [those with] severe disease progression.
The overall costs per patient-year resulting from inpatient stays (6,634€, or about $7,700) were higher than outpatient medication costs (658€, or about $710), as well as costs for aids and remedies (1,128€, about $1,20).
Mean inpatient costs per patient-year were higher in those on intensified treatment (38,669€, about $42,000) than in those receiving standard treatment (2,980€, or about $3,200) or no treatment (887€, about $950).
“We have demonstrated that the burden of [MG] encompasses an economic dimension,” the researchers wrote. “Specifically, persons affected by MG experience limitations in occupational engagement and income, while society faces significant financial burdens, particularly in cases of [patients who are] young, working, individuals and [those with] severe disease progression.”
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