Healthcare resources utilisation in primary progressive multiple sclerosis
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Epidemiological data on primary progressive multiple sclerosis (PPMS) are scarce. This study was aimed to evaluate the burden of PPMS in Italy with healthcare resources utilisation and costs for Italian National Health System (INHS). A 2-year cross-sectional analysis of real-world data collected in the ARCO database, covering > 10 million Italian inhabitants, was performed. From a cohort of patients affected by MS in 2014, those supposedly affected by PPMS were defined by the concurrent matching of absence of disease-modifying treatments and use of rehabilitation services. Any other drug prescriptions, outpatient services and hospitalisations were analysed in 2015 for each subject. The average annual cost per patient was provided both for each expenditure item and by integrating these. Of 13,253,591 inhabitants, 18,453 resulted affected by MS (prevalence 139 × 100,000). Of these, 1849 agreed with additional criteria to identify PPMS (10% of MS population). The 26.8% of these experienced at least one admission in 1 year, 97.3% used at least one outpatient service and 94.3% received at least one reimbursed drug. In the perspective of INHS, PPMS generated an average annual cost of € 3783 per person: 49% for hospitalisations, 28% for outpatient services and 23% for drugs. This study provides a reliable estimation of the PPMS burden in Italy, in terms of healthcare utilisation and direct costs. These findings could be useful to estimate the changes in health expenditure following the incoming of new drugs to treat PPMS with increase of pharmaceutical cost and potential decrease of rehabilitation and hospitalisation costs.
KeywordsPrimary progressive multiple sclerosis Real-world evidence Burden of disease Italy Administrative databases
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 14.Wolinsky JS, Narayana PA, O'Connor P, Coyle PK, Ford C, Johnson K, Miller A, Pardo L, Kadosh S, Ladkani D (2007) Glatiramer acetate in primary progressive multiple sclerosis: results of a multinational, multicenter, double-blind, placebo-controlled trial. Ann Neurol 61(1):14–24. https://doi.org/10.1002/ana.21079 CrossRefPubMedGoogle Scholar
- 15.Hawker K, O’Connor P, Freedman MS, Calabresi PA, Antel J, Simon J, Hauser S, Waubant E, Vollmer T, Panitch H, Zhang J, Chin P, Smith CH (2009) Rituximab in patients with primary progressive multiple sclerosis: results of a randomized double-blind placebo-controlled multicenter trial. Ann Neurol 66(4):460–471. https://doi.org/10.1002/ana.21867 CrossRefPubMedGoogle Scholar
- 16.Lublin F, Miller DH, Freedman MS, Cree BAC, Wolinsky JS, Weiner H, Lubetzki C, Hartung HP, Montalban X, Uitdehaag BMJ, Merschhemke M, Li B, Putzki N, Liu FC, Haring DA, Kappos L (2016) Oral fingolimod in primary progressive multiple sclerosis (INFORMS): a phase 3, randomised, double-blind, placebo-controlled trial. Lancet 387(10023):1075–1084. https://doi.org/10.1016/s0140-6736(15)01314-8 CrossRefPubMedGoogle Scholar
- 18.Calabria S, Cinconze E, Rossini M, Rossi E, Maggioni AP, Pedrini A, De Rosa M (2016) Adherence to alendronic or risedronic acid treatment, combined or not to calcium and vitamin D, and related determinants in Italian patients with osteoporosis. Patient Prefer Adherence 10:523–530. https://doi.org/10.2147/ppa.s95634 CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Bargagli AM, Colais P, Agabiti N, Mayer F, Buttari F, Centonze D, Di Folco M, Filippini G, Francia A, Galgani S, Gasperini C, Giuliani M, Mirabella M, Nociti V, Pozzilli C, Davoli M (2016) Prevalence of multiple sclerosis in the Lazio region, Italy: use of an algorithm based on health information systems. J Neurol 263(4):751–759. https://doi.org/10.1007/s00415-016-8049-8 CrossRefPubMedPubMedCentralGoogle Scholar
- 21.Bezzini D, Policardo L, Meucci G, Ulivelli M, Bartalini S, Profili F, Battaglia MA, Francesconi P (2016) Prevalence of multiple sclerosis in Tuscany (Central Italy): a study based on validated administrative data. Neuroepidemiology 46(1):37–42. https://doi.org/10.1159/000441567 CrossRefPubMedGoogle Scholar
- 24.Gini R, Schuemie MJ, Pasqua A, Carlini E, Profili F, Cricelli I, Dazzi P, Barletta V, Francesconi P, Lapi F, Donatini A, Dal Co G, Visca M, Bellentani M, Sturkenboom M, Klazinga N (2017) Monitoring compliance with standards of care for chronic diseases using healthcare administrative databases in Italy: strengths and limitations. PLoS One 12(12):e0188377. https://doi.org/10.1371/journal.pone.0188377 CrossRefPubMedPubMedCentralGoogle Scholar