NMOSD, MOGAD have significant individual, societal costs

Neuromyelitis optica spectrum disorders and myelin oligodendrocyte glycoprotein-antibody associated disease incur significant costs for individuals, their families and for society, according to study results published in Neurology.

“Until summer 2019, [neuromyelitis optica spectrum disorder (NMOSD)] was globally treated off-label with standard immunotherapeutics, preferably rituximab, azathioprine or mycophenolate mofetil,” Martin W. Hümmert, MD, of the department of neurology at Hannover Medical School in Germany, and colleagues wrote. “New treatments have been and are still being implemented, since four phase 3 trials indicate benefits for these new therapeutics of NMOSD. Approval has already been granted in several countries for eculizumab, satralizumab and inebilizumab.

“Given the extraordinarily high costs of the new drugs, a standardized and up-to-date analysis of the ‘pre-new therapy era’ costs of this disease is overdue as guidance for physicians, health policy makers and health care providers,” they added.

Hümmert and colleagues noted data are lacking on costs and health-related quality of life (HRQoL) for myelin oligodendrocyte glycoprotein-antibody associated disease (MOGAD), highlighting a need for independent research on disease costs and quality of life for this disease and NMOSD.

In the current multicenter cross-sectional study, researchers used patient questionnaires to collect data on consumption of medical and nonmedical resources and work ability, with costs analyzed in Euros for 2018 from the societal perspective. Further, they used the EuroQoL EQ-5D5L to obtain data on HRQoL and the Neuromyelitis Optica Study Group database to obtain clinical data. They analyzed data from 212 patients (80% women; median age, 50 years; median disease duration, 7 years; median Expanded Disability Status Scale [EDSS] score, 3.5).

Results showed a mean total annual per capita cost of illness of 59,574 Euros ($70,297) and a mean index value of the EQ-5D-5L of 0.693. Informal care costs (28% of total costs), indirect costs (23%) and drugs (16%), particularly immunotherapeutics, represented the most significant drivers of cost. Researchers noted a positive association between costs and disease severity, with mean annual costs of 129,687 Euros ($153,031) in the EDSS 6.5-8.5 subgroup. HRQoL appeared negatively associated with disease severity, with an EQ-5D-5L mean index value of 0.195 in the EDSS 6.5-8.5 subgroup. Antibody status and disease duration did not affect the total annual costs or HRQoL.

“These findings support an early, individually tailored and cost-effective therapy to prevent long-term disability and preserve quality of life,” Hümmert and colleagues wrote.