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Costs and health-related quality of life in patients with NMO spectrum disorders and MOG-antibody-associated disease: CHANCE(NMO) study

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Item Type:Article
Title:Costs and health-related quality of life in patients with NMO spectrum disorders and MOG-antibody-associated disease: CHANCE(NMO) study
Creators Name:Hümmert, M.W. and Schöppe, L.M. and Bellmann-Strobl, J. and Siebert, N. and Paul, F. and Duchow, A. and Pellkofer, H. and Kümpfel, T. and Havla, J. and Jarius, S. and Wildemann, B. and Berthele, A. and Bergh, F.T. and Pawlitzki, M. and Klotz, L. and Kleiter, I. and Stangel, M. and Gingele, S. and Weber, M.S. and Faiss, J.H. and Pul, R. and Walter, A. and Zettl, U. and Senel, M. and Stellmann, J.P. and Häußler, V. and Hellwig, K. and Ayzenberg, I. and Aktas, O. and Ringelstein, M. and Schreiber-Katz, O. and Trebst, C.
Abstract:OBJECTIVE: To evaluate costs and health-related quality of life (HRQoL) of neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein-antibody associated disease (MOGAD).MethodsIn this multicenter cross-sectional study, data on consumption of medical and non-medical resources and work ability were assessed via patient questionnaires. Costs were analyzed in EUR for 2018 from the societal perspective. HRQoL was captured by the EuroQoL EQ-5D-5L questionnaire. Clinical data were retrieved from the Neuromyelitis Optica Study Group (NEMOS) database. RESULTS: Two hundred twelve patients (80% women; median age 50 [19-83] years; median disease duration 7 [0-43] years; median Expanded Disability Status Scale [EDSS] 3.5 [0-8.5]; 66% Aquaporin-4 IgG, 22% MOG IgG positive, 12% double seronegative) were analyzed. The mean total annual per capita cost of illness accounted for EUR (Euro) 59 574 (95% CI 51 225 to 68 293; USD [United States dollars] 70 297, 95% CI 60 445 to 80 586), and the mean index value of the EQ-5D-5L was 0.693 (95% CI 0.65 to 0.73). The most important cost drivers were informal care costs (28% of total costs), indirect costs (23%) and drugs (16%), especially immunotherapeutics. Costs showed a positive correlation with disease severity (ρ=0.56, 95% CI 0.45 to 0.65); in the EDSS 6.5-8.5 subgroup the mean annual costs were EUR 129 687 (95% CI 101 946 to 160 336; USD 153 031, 95% CI 120 296 to 189 196). The HRQoL revealed a negative correlation to disease severity (ρ=-0.69, 95% CI -0.76 to -0.61); in the EDSS 6.5-8.5 subgroup the EQ-5D-5L mean index value was 0.195 (95% CI 0.13 to 0.28). Neither antibody status nor disease duration influenced the total annual costs or HRQoL. CONCLUSION: These German data from the era without approved preventive immunotherapies show enormous effects of the diseases on costs and quality of life. An early and cost-effective therapy should be provided to prevent long-term disability and preserve quality of life.
Keywords:Aquaporin 4, Autoantibodies, Cross-Sectional Studies, Myelin-Oligodendrocyte Glycoprotein, Neuromyelitis Optica, Quality of Life
Source:Neurology
ISSN:0028-3878
Publisher:American Academy of Neurology
Volume:98
Number:11
Page Range:e1184-e1196
Date:15 March 2022
Official Publication:https://doi.org/10.1212/WNL.0000000000200052
PubMed:View item in PubMed

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