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The Economic and Humanistic Burden of Pediatric-Onset Multiple Sclerosis
Nupur Greene1, Lita Araujo1, Cynthia Campos2
1Health Economics & Value Assessment, Sanofi, Cambridge, Massachusetts.
Insights
Pediatric-onset multiple sclerosis (POMS) leads to significantly higher healthcare use and costs. Patients with POMS also experience reduced quality of life and increased fatigue compared to healthy peers.
Area of Science:
- Neurology
- Pediatrics
- Health Economics
Background:
- Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease affecting the central nervous system.
- Pediatric-onset MS (POMS), diagnosed before age 18, represents 2-5% of the global MS population.
- Understanding the economic and quality-of-life (QOL) impact of POMS is crucial for patient care and resource allocation.
Purpose of the Study:
- To review the literature on healthcare resource utilization (HCRU) and costs associated with POMS.
- To assess the quality-of-life (QOL) outcomes in pediatric patients diagnosed with MS.
- To provide a comprehensive overview of the global economic and humanistic burden of POMS.
Main Methods:
- Systematic literature review of English-language studies published after September 2010.
- Searches conducted in MEDLINE and Embase databases.
- Focused on studies reporting HCRU, costs, insurance coverage, and QOL in POMS patients.
Main Results:
- Patients with POMS exhibited higher rates of primary care visits, hospital visits, and admissions compared to healthy controls.
- Annual per-patient costs in the US averaged $5907, with hospital stays costing approximately $38,543.
- POMS patients reported lower QOL and higher fatigue scores (using PedsQL™ measures) than healthy children and adolescents.
Conclusions:
- Healthcare resource utilization and associated costs are substantially elevated in the POMS population.
- Pediatric-onset MS significantly impacts patients' quality of life, manifesting as reduced well-being and increased fatigue.
- Further research into HCRU and costs is needed for a more robust understanding of the economic burden of POMS.
Abstract:
Background: Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system. Pediatric-onset MS (POMS), defined as onset of MS before 18 years of age, is estimated to account for 2% to 5% of the MS population worldwide. Objectives: To conduct a literature review focused on the healthcare resource utilization and cost as well as quality-of-life (QOL) outcomes among patients with POMS. Methods: We conducted a systematic literature review of English-language studies published after September 2010 in MEDLINE and Embase to describe the global economic healthcare resource utilization and costs and humanistic (QOL) burden in patients with POMS. Results: We found 11 studies that reported on healthcare resource utilization, cost, or insurance coverage and 36 studies that reported on QOL outcomes in patients with POMS. Patients with POMS had higher rates of primary care visits (1.41 [1.29-1.54]), hospital visits (10.74 [8.95-12.90]), and admissions (rate ratio, 4.27 [2.92-6.25];OR, 15.2 [12.0-19.1]) compared with healthy controls. Mean per-patient costs in the United States were $5907 across all settings per year of follow-up between 2002 and 2012; mean costs per hospital stay were $38 543 (in 2015 USD) between 2004 and 2013. Three studies reported psychosocial scores between 71.59 and 79.7, and 8 studies reported physical health scores between 74.62 to 82.75 using the Pediatric Quality of Life Measurement Model (PedsQLTM). Twelve studies used the PedsQL™ Multidimensional Fatigue Scale. Mean scores on the self-reported general fatigue scale ranged from 63.15 to 78.5. Quality-of-life scores were lower than those of healthy controls. Discussion: Our review presents a uniquely broad and recent overview of the global economic and humanistic burden of patients with POMS. Additional research on healthcare resource utilization and cost would provide a more robust understanding of the economic burden in this population. Conclusions: Healthcare resource utilization and costs are high in this population, and patients report reduced QOL and significant fatigue compared with healthy children and adolescents.
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