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Frequency and economic impact of comorbid cardiac conditions with multiple sclerosis
Meg A Franklin1, Laura E Happe, Rachel Dillman
1300 Calvert Ave., Clinton, SC 29325. mfranklin.fpc@gmail.com.
Insights
Nearly 10% of multiple sclerosis (MS) hospitalizations involve cardiac conditions, increasing costs. These findings impact treatment decisions for MS patients with heart issues.
Area of Science:
- Cardiology
- Neurology
- Health Economics
Background:
- Fingolimod, an oral therapy for multiple sclerosis (MS), has contraindications for patients with specific cardiac conditions.
- The prevalence of these cardiac contraindications in MS patients is not well-established.
- This study investigates the frequency and economic burden of cardiac conditions in hospitalized MS patients.
Purpose of the Study:
- To determine the frequency of selected cardiac conditions in patients diagnosed with multiple sclerosis (MS).
- To assess the economic impact of these comorbid cardiac conditions on MS hospitalizations.
Main Methods:
- A retrospective cohort study analyzed hospital discharge data from 2006-2010.
- Identified MS patients with cardiac conditions listed as contraindications for fingolimod.
- Compared hospitalization costs between MS patients with and without these cardiac conditions.
Main Results:
- Out of 136,542 MS discharges, 9.2% had a relevant comorbid cardiac condition.
- Heart failure (59.4%), myocardial infarction (17.2%), and cerebral artery occlusion (12.4%) were most common.
- Hospitalizations with cardiac conditions cost significantly more ($17,623 vs. $11,663 per discharge).
Conclusions:
- Comorbid cardiac conditions are common in hospitalized MS patients, significantly increasing healthcare costs.
- These findings highlight the need for careful consideration of cardiac health when prescribing immunomodulatory therapies for MS.
- Health plans should evaluate coverage criteria and clinical programs for MS patients with co-existing cardiac diseases.
Background:
Fingolimod, an oral immunomodulatory therapy approved to treat multiple sclerosis (MS) is contraindicated in patients with certain cardiac conditions, yet the frequency of these conditions in patients with MS is not known. This study assessed the frequency and economic impact of cardiac conditions among hospitalizations of patients with MS.
Objective:
To determine the frequency and economic impact of selected comorbid cardiac conditions among hospitalizations of patients with a diagnosis of MS.
Methods:
This was a retrospective, discharge-level cohort study of hospital discharge data from 2006-2010. The frequencies of cardiac conditions of interest (based on contraindications to fingolimod in the prescribing information) were reported among all discharges with a diagnosis of MS. Two cohorts were defined: (1) MS with cardiac condition of interest and (2) MS with no cardiac condition of interest. The mean adjusted cost per discharge and incremental cost per hospital day were reported.
Results:
Among 136,542 discharges with a diagnosis of MS, 9.2% (n = 12,504) had a comorbid cardiac condition of interest based on contraindications to fingolimod in the prescribing information. Heart failure (59.4%), myocardial infarction (17.2%), and occlusion of cerebral arteries (12.4%) were the most common cardiac conditions. The mean adjusted cost per discharge was significantly higher for the MS with cardiac condition cohort compared with the MS with no cardiac condition cohort ($17,623 vs. $11,663, P less than 0.0001). The incremental cost per hospital day was $6,479 for the MS with cardiac condition cohort.
Conclusions:
The presence of comorbid cardiac conditions among hospital discharges in patients with MS is substantial and associated with higher hospitalization costs. Health plans should give consideration to the overlapping presence of these diseases when determining coverage criteria for immunomodulatory therapies and designing clinical programs for MS.
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