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Cost analysis of methylprednisolone treatment of multiple sclerosis patients
1Institute for Work and Health, Toronto, Canada.
Background:
Intravenous methylprednisolone (IVMP) is the treatment of choice for multiple sclerosis (MS) patients undergoing acute exacerbation of disease symptoms and yet its cost has not been accurately determined. Determination of this cost in different settings is also pertinent to consideration of cost-saving alternatives to in-patient treatment.
Methods:
Cost analysis from the point of view of the health care system of IVMP treatment of MS patients receiving treatment in association with a selected Toronto teaching hospital in fiscal year 1994/95 was carried out. Costs of any concurrent treatments were excluded.
Results:
Total cost for 92 patients, based on a 4 dose regime, was estimated to be $78,527. The the cost per patient was $1,1181.84 for in-patients (IP), $714.64 for out-patients of the MS Clinic (OP) and $774.21 for patients whose treatment was initiated in the Clinic, but completed in the home (HC). Sensitivity analyses indicated: 1) IP treatment was in all cases more expensive than that of OP or HC; 2) the cost savings of OP vs. HC was sensitive to assumptions made regarding Clinic overhead, Clinic nursing costs and Home Care Program overhead.
Conclusion:
Alternatives to in-patient care must be considered carefully. In this study, both out-patient and in-home treatment were cost-saving alternatives to in-patient treatment, but large differences in the cost of hospital out-patient vs. in-home care could not be demonstrated.
Insights
Intravenous methylprednisolone (IVMP) for multiple sclerosis (MS) exacerbations is costly. Out-patient and in-home treatments offer significant cost savings compared to in-patient care.
Area of Science:
- Neurology
- Health Economics
Background:
- Intravenous methylprednisolone (IVMP) is a standard treatment for multiple sclerosis (MS) exacerbations.
- The precise cost of IVMP treatment has not been well-established.
- Understanding treatment costs is crucial for evaluating cost-saving alternatives.
Purpose of the Study:
- To determine the cost of IVMP treatment for MS patients.
- To compare the costs of in-patient, out-patient, and home-care treatment settings.
Main Methods:
- A cost analysis was performed from a healthcare system perspective.
- Data was collected for MS patients treated at a Toronto teaching hospital during fiscal year 1994/95.
- Costs of concurrent treatments were excluded from the analysis.
Main Results:
- The total cost for 92 patients on a 4-dose regimen was $78,527.
- Cost per patient: $1,118.84 (in-patient), $714.64 (out-patient clinic), $774.21 (home care).
- In-patient treatment was consistently more expensive than out-patient or home care.
Conclusions:
- Out-patient and in-home IVMP administration are cost-saving alternatives to in-patient treatment for MS exacerbations.
- The cost difference between out-patient and in-home care is sensitive to overhead assumptions.
- Careful consideration of alternative treatment settings is warranted.