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Social/economic costs and health-related quality of life of mucopolysaccharidosis patients and their caregivers in Europe

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Abstract

Objectives

To assess the health-related quality of life (HRQOL) of patients with mucopolysaccharidosis (MPS) and their caregivers and to quantify the disease-related costs from a societal perspective.

Methods

In the context of a multi-country study of rare diseases (BURQOL-RD project), a cross-sectional survey was performed among MPS patients in seven European countries. Data on demographic characteristics, health resource utilization, informal care, and loss of labor productivity were collected. The EQ-5D, Barthel index (BI), and Zarit burden interview (ZBI) questionnaires were used to assess patients’ and their informal caregivers’ quality of life, patients’ functional ability, and caregivers’ burden, respectively.

Results

Altogether, 120 patients (children 62 %, females 40 %) and 66 caregivers completed the questionnaire. Patients’ mean age was 16.5 years and median age at diagnosis was 3 years. Adult patients’ average EQ-5D and EQ VAS scores varied across countries from 0.13 to 0.43 and 30.0 to 62.2, respectively, mean BI was 46.7, and ZBI was 32.7. Mean informal care time was 51.3 h/week. The mean total annual cost per patient (reference year 2012) was €24,520 in Hungary, €25,993 in France, €84,921 in Italy, €94,384 in Spain, and €209,420 in Germany. Costs are also shown to differ between children and adults. Direct costs accounted for most of the costs in all five countries (80, 100, 99, 98, and 93 %, respectively).

Conclusions

MPS patients experience substantial loss of HRQOL and their families take a remarkable part in their care. Although utilization of health and social care resources varies significantly across countries, MPS incurs considerable societal costs in all the countries studied.

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References

  1. Muenzer, J.: The mucopolysaccharidoses: a heterogeneous group of disorders with variable pediatric presentations. J. Pediatr. 144, S27–S34 (2004)

    Article  CAS  PubMed  Google Scholar 

  2. Muenzer, J.: Overview of the mucopolysaccharidoses. Rheumatology (Oxford) 50, v4–v12 (2011)

    Article  CAS  Google Scholar 

  3. Braunlin, E.A., Harmatz, P.R., Scarpa, M., Furlanetto, B., Kampmann, C., Loehr, J.P., Ponder, K.P., Roberts, W.C., Rosenfeld, H.M., Giugliani, R.: Cardiac disease in patients with mucopolysaccharidosis: presentation, diagnosis and management. J. Inherit. Metab. Dis. 34, 1183–1197 (2011)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Ashworth, J., Flaherty, M., Pitz, S., Ramlee, A.: Assessment and diagnosis of suspected glaucoma in patients with mucopolysaccharidosis. Acta Ophthalmol. 93, e111–e117 (2015)

    Article  PubMed  Google Scholar 

  5. Berger, K.I., Fagondes, S.C., Giugliani, R., Hardy, K.A., Lee, K.S., McArdle, C., Scarpa, M., Tobin, M.J., Ward, S.A., Rapoport, D.M.: Respiratory and sleep disorders in mucopolysaccharidosis. J. Inherit. Metab. Dis. 36, 201–210 (2013)

    Article  CAS  PubMed  Google Scholar 

  6. Cimaz, R., La Torre, F.: Mucopolysaccharidoses. Curr. Rheumatol. Rep. 16, 389 (2014)

    Article  PubMed  Google Scholar 

  7. Leadley, R.M., Lang, S., Misso, K., Bekkering, T., Ross, J., Akiyama, T., Fietz, M., Giugliani, R., Hendriksz, C.J., Hock, N.L., McGill, J., Olaye, A., Jain, M., Kleijnen, J.: A systematic review of the prevalence of Morquio A syndrome: challenges for study reporting in rare diseases. Orphanet. J. Rare Dis. 9, 173 (2014)

    Article  PubMed  PubMed Central  Google Scholar 

  8. Jurecka, A., Lugowska, A., Golda, A., Czartoryska, B., Tylki-Szymanska, A.: Prevalence rates of mucopolysaccharidoses in Poland. J. Appl. Genet. 56, 205–210 (2015)

    Article  PubMed  Google Scholar 

  9. EMA: Relevant sources for orphan disease prevalence data. http://www.ema.europa.eu/docs/en_GB/document_library/Other/2012/07/WC500130297.pdf (2014). Accessed 31 Oct 2015

  10. Noh, H., Lee, J.I.: Current and potential therapeutic strategies for mucopolysaccharidoses. J. Clin. Pharm. Ther. 39, 215–224 (2014)

    Article  CAS  PubMed  Google Scholar 

  11. Schlander, M., Beck, M.: Expensive drugs for rare disorders: to treat or not to treat? The case of enzyme replacement therapy for mucopolysaccharidosis VI. Curr. Med. Res. Opin. 25, 1285–1293 (2009)

    Article  CAS  PubMed  Google Scholar 

  12. Szegedi, M., Molnar, M.J., Boncz, I., Kosztolanyi, G.: Shift of focus in the financing of Hungarian drugs. Reimbursement for orphan drugs for treating rare diseases: financing of enzyme replacement therapy in Hungary. Orv. Hetil. 155, 1735–1741 (2014)

    Article  PubMed  Google Scholar 

  13. Drummond, M., Towse, A.: Orphan drugs policies: a suitable case for treatment. Eur. J. Health Econ. 15, 335–340 (2014)

    Article  PubMed  Google Scholar 

  14. Angelis, A., Tordrup, D., Kanavos, P.: Socio-economic burden of rare diseases: a systematic review of cost of illness evidence. Health Policy 119, 964–979 (2015)

    Article  PubMed  Google Scholar 

  15. Linertova, R., Serrano-Aguilar, P., Posada-de-la-Paz, M., Hens-Perez, M., Kanavos, P., Taruscio, D., Schieppati, A., Stefanov, R., Pentek, M., Delgado, C., von der Schulenburg, J.M., Persson, U., Chevreul, K., Fattore, G., Worbes-Cerezo, M., Sefton, M., Lopez-Bastida, J.: Delphi approach to select rare diseases for a European representative survey. BURQOL-RD Study Health Policy 108, 19–26 (2012)

    Article  PubMed  Google Scholar 

  16. Pentek, M., Kosztolanyi, G., Melegh, B., Halasz, A., Pogany, G., Baji, P., Brodszky, V., Vartokne, H.N., Boncz, I., Gulacsi, L.: Cystic fibrosis—disease burden and health-related quality of life of patients and their caregivers: results of the European BURQOL-RD survey in Hungary. Orv. Hetil. 155, 1673–1684 (2014)

    Article  PubMed  Google Scholar 

  17. Chevreul, K., Brigham, K.B., Michel, M., Rault, G.: Costs and health-related quality of life of patients with cystic fibrosis and their carers in France. J. Cyst. Fibros. 14, 384–391 (2015)

    Article  PubMed  Google Scholar 

  18. Drummond, M., O’Brien, B., Stoddart, G., Torrance, G.: Methods for the economic evaluation of health care programmes, 2nd edn. Oxford University Press, Oxford (1997)

    Google Scholar 

  19. McDaid, D.: Estimating the costs of informal care for people with Alzheimer’s disease: methodological and practical challenges. Int. J. Geriatr. Psychiatry 16, 400–405 (2001)

    Article  CAS  PubMed  Google Scholar 

  20. van den Berg, B., Brouwer, W.B., Koopmanschap, M.A.: Economic valuation of informal care. An overview of methods and applications. Eur. J. Health Econ. 5, 36–45 (2004)

    Article  PubMed  Google Scholar 

  21. Hodgson, T.A., Meiners, M.R.: Cost-of-illness methodology: a guide to current practices and procedures. Milbank Mem. Fund Q. Health Soc. 60, 429–462 (1982)

    Article  CAS  PubMed  Google Scholar 

  22. Dolan, P.: Modeling valuations for EuroQol health states. Med. Care 35(11), 1095–1108 (1997)

    Article  CAS  PubMed  Google Scholar 

  23. Szende, Á., Oppe, M., Devlin, N. (eds.): EQ-5D value sets: inventory, comparative review and user guide. Springer, Netherlands (2007)

  24. Mahoney, F.I., Barthel, D.W.: Functional evaluation: the Barthel index. Md. State Med. J. 14, 61–65 (1965)

    CAS  PubMed  Google Scholar 

  25. Shah, S., Vanclay, F., Cooper, B.: Improving the sensitivity of the Barthel index for stroke rehabilitation. J. Clin. Epidemiol. 42, 703–709 (1989)

    Article  CAS  PubMed  Google Scholar 

  26. Hébert, R., Bravo, G., Préville, M.: Reliability, validity, and reference values of the Zarit burden interview for assessing informal caregivers of community-dwelling older persons with dementia. Can. J. Aging 19, 494–507 (2000)

    Article  Google Scholar 

  27. Szende, A., Nemeth, R.: Health-related quality of life of the Hungarian population. Orv. Hetil. 144(34), 1667–1674 (2003)

    PubMed  Google Scholar 

  28. Connock, M., Juarez-Garcia, A., Frew, E., Mans, A., Dretzke, J., Fry-Smith, A., Moore, D.: A systematic review of the clinical effectiveness and cost-effectiveness of enzyme replacement therapies for Fabry’s disease and mucopolysaccharidosis type 1. Health Technol. Assess. 10(20), iii–iv, ix–113 (2006)

  29. Hendriksz, C.J., Lavery, C., Coker, M., Ucar, S.K., Jain, M., Bell, L., Lampe, C.: Burden of disease in patients with Morquio A syndrome: results from an international patient-reported outcomes survey. Orphanet J. Rare Dis. 9, 32 (2014)

    Article  PubMed  PubMed Central  Google Scholar 

  30. Guffon, N., Heron, B., Chabrol, B., Feillet, F., Montauban, V., Valayannopoulos, V.: Diagnosis, quality of life, and treatment of patients with Hunter syndrome in the French healthcare system: a retrospective observational study. Orphanet J. Rare Dis. 10, 43 (2015)

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

The authors wish to thank: National Alliance of People with Rare Diseases (NAPRD), Bulgaria; Alliance Maladies Rares, France; ACHSE, Germany; Hungarian Federation of People with Rare and Congenital Diseases (RIROSZ), Hungary; Federazione Italiana Malattie Rare (UNIAMO), Italy; the Consulta Nazionale delle Malattie Rare, Italy; Rare Diseases Sweden; Federación Española de Efermedades Raras (FEDER), Spain; Rare Disease UK and Rare Diseases Europe (EURORDIS); National Mucopolysaccharidosis Association, Bulgaria; Gesellschaft für Mukopolysaccharidosen e.V., Germany; Magyar Mukopoliszaccharidózis Társaság, Hungary, A.I.MPSAssociazione italiana mucopolisaccaridosi e malattie affini, Italy; Asociación Española de las Mucopolisacaridosis y Síndromes Relacionados and Asociación Valenciana de Sanfilippo i altres mucopolisacaridosis, Spain.

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Correspondence to Márta Péntek.

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Funding

Supported by the Social/Economic Burden and Health-Related Quality of Life in Patients with Rare Diseases in Europe Project, which received funding from the European Union within the framework of the Health Programme [Grant A101205]. The Executive Agency of the European Union is not responsible for any use that may be made of the information contained herein.

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The authors declare that they have no conflicts of interest.

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Members of the BURQOL-RD Research Network listed in Supplementary Annex 1.

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Péntek, M., Gulácsi, L., Brodszky, V. et al. Social/economic costs and health-related quality of life of mucopolysaccharidosis patients and their caregivers in Europe. Eur J Health Econ 17 (Suppl 1), 89–98 (2016). https://doi.org/10.1007/s10198-016-0787-0

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  • DOI: https://doi.org/10.1007/s10198-016-0787-0

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