Real-World Evidence on the influence of relapses and relapse associated progression on societal economic costs in patients with multiple sclerosis
ECTRIMS Online Library. Ness N. 09/13/19; 279552; 291
Nils-Henning Ness
Nils-Henning Ness
Contributions
Abstract

Abstract: 291

Type: Scientific Session

Abstract Category: Clinical aspects of MS - Economic burden

N.-H. Ness1, D. Schriefer1, R. Haase1, B. Ettle2, M. Wunderlich1, K. Akgün1, T. Ziemssen1

1Center of Clinical Neuroscience | Department of Neurology, University Hospital Dresden, Dresden, 2Novartis Pharma GmbH, Nuremberg, Germany

Background: In Multiple Sclerosis, relapses considerably impact health related quality of life and lead to high societal economic burden due to the need of additional medical and non-medical services. However, costs of relapses are difficult to determine considering the variability in disease course as well as patient characteristics. Due to their mostly descriptive nature, conclusions from existing real world analysis are limited and real societal costs of relapses and relapse associated worsening (RAW) remain not well understood.
Objective: To quantify the impact of relapses and RAW on societal economic burden.
Methods: We analyzed data from two large German longitudinal observational multicenter studies in which both economic and clinical data were collected. Relapses were assessed in accordance to clinical judgement of physicians during routine visits every 3 months. RAW was defined as a confirmed disability progression after 6 month associated with one or multiple relapse(s). A multivariate generalized linear mixed model with a negative binomial distribution was used to estimate the effect of the number of relapses in two years on total, direct medical, direct non-medical and indirect costs. Effects are adjusted for age-, gender and EDSS. Patients achieving clinical 'no evidence of disease activity' (NEDA) were assigned as the reference group.
Results: In total 1546 patients were included in the analysis whereby 988 achieved clinical NEDA, 408 had one or multiple relapses and 150 patients had RAW within two years. Mean quarterly societal costs excluding DMTs are 1746€ (SD: 83€) for patients achieving clinical NEDA but increase by 825€ (SD: 144€) for patients with relapse(s) and by 897€ (SD: 222€) if the patient had RAW (p< 0.05). Impact of relapses and RAW is most striking in terms of work-related indirect costs. Those increase for patients with relapse(s) and RAW by 577€ (SD: 131€) and 572€ (SD: 193€), respectively (p< 0.05).
Conclusion: Relapses and RAW contribute to a statistically significant increase in societal economic burden especially regarding work-related indirect costs. Adjustment for parameters influencing the course of the disease support the reliability of the results.
Disclosure: NHN has received research funding from Novartis.
DS and MW have nothing to disclose
RH has received speaker fees from Sanofi and travel grants from Celgene.
BE is an employee of Novartis.
KA has received personal compensation for consulting services from Biogen, Novartis, and Roche.
TZ has received personal compensation from Almirall, Biogen, Bayer, Celgene, Novartis, Roche, Sanofi, Teva for consulting and speaking services and he is the section editor for BMC Neurology. Additionally, he received financial support for research activities from BAT, Biogen Novartis, Teva and Sanofi

Abstract: 291

Type: Scientific Session

Abstract Category: Clinical aspects of MS - Economic burden

N.-H. Ness1, D. Schriefer1, R. Haase1, B. Ettle2, M. Wunderlich1, K. Akgün1, T. Ziemssen1

1Center of Clinical Neuroscience | Department of Neurology, University Hospital Dresden, Dresden, 2Novartis Pharma GmbH, Nuremberg, Germany

Background: In Multiple Sclerosis, relapses considerably impact health related quality of life and lead to high societal economic burden due to the need of additional medical and non-medical services. However, costs of relapses are difficult to determine considering the variability in disease course as well as patient characteristics. Due to their mostly descriptive nature, conclusions from existing real world analysis are limited and real societal costs of relapses and relapse associated worsening (RAW) remain not well understood.
Objective: To quantify the impact of relapses and RAW on societal economic burden.
Methods: We analyzed data from two large German longitudinal observational multicenter studies in which both economic and clinical data were collected. Relapses were assessed in accordance to clinical judgement of physicians during routine visits every 3 months. RAW was defined as a confirmed disability progression after 6 month associated with one or multiple relapse(s). A multivariate generalized linear mixed model with a negative binomial distribution was used to estimate the effect of the number of relapses in two years on total, direct medical, direct non-medical and indirect costs. Effects are adjusted for age-, gender and EDSS. Patients achieving clinical 'no evidence of disease activity' (NEDA) were assigned as the reference group.
Results: In total 1546 patients were included in the analysis whereby 988 achieved clinical NEDA, 408 had one or multiple relapses and 150 patients had RAW within two years. Mean quarterly societal costs excluding DMTs are 1746€ (SD: 83€) for patients achieving clinical NEDA but increase by 825€ (SD: 144€) for patients with relapse(s) and by 897€ (SD: 222€) if the patient had RAW (p< 0.05). Impact of relapses and RAW is most striking in terms of work-related indirect costs. Those increase for patients with relapse(s) and RAW by 577€ (SD: 131€) and 572€ (SD: 193€), respectively (p< 0.05).
Conclusion: Relapses and RAW contribute to a statistically significant increase in societal economic burden especially regarding work-related indirect costs. Adjustment for parameters influencing the course of the disease support the reliability of the results.
Disclosure: NHN has received research funding from Novartis.
DS and MW have nothing to disclose
RH has received speaker fees from Sanofi and travel grants from Celgene.
BE is an employee of Novartis.
KA has received personal compensation for consulting services from Biogen, Novartis, and Roche.
TZ has received personal compensation from Almirall, Biogen, Bayer, Celgene, Novartis, Roche, Sanofi, Teva for consulting and speaking services and he is the section editor for BMC Neurology. Additionally, he received financial support for research activities from BAT, Biogen Novartis, Teva and Sanofi

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