Economic burden of spinal muscular atrophy: an analysis of claims data. Issue 1 (1st January 2020)

• Record Type: Journal Article
• Authors: Belter, Lisa; Cruz, Rosángel; Kulas, Sierra; McGinnis, Emily; Dabbous, Omar; Jarecki, Jill
• Is Part Of: Journal of market access & health policy. Volume 8:Issue 1(2020)
• Publication Date: 2020-01-01
• Subjects: Spinal muscular atrophy -- cost -- economic burden -- infantile -- child -- juvenile; Medical policy -- Periodicals; Medical policy -- Economic aspects -- Periodicals; International trade -- Environmental aspects -- Periodicals; Health Policy -- economics; Technology Assessment, Biomedical; Marketing of Health Services; International trade -- Environmental aspects; Medical policy; Periodicals; Periodicals; Fulltext; Internet Resources; Periodicals; 362.1
• DOI: 10.1080/20016689.2020.1843277
• Languages: English
• ISSNs: 2001-6689

Abstract

ABSTRACT: Background : Spinal muscular atrophy (SMA) is a rare genetic neuromuscular disease. Objective : Characterize direct costs associated with SMA management. Data source : Truven Health Analytics MarketScan claims data (2012–2016). Patients : Eligible patients had ≥2 SMA-related medical claims ≥30 days apart. Patients were matched (1:1) to controls by birth year, gender, and geographic region. Patients were categorized as having infantile, child, or juvenile SMA based on diagnosis at age <1, 1–3, or 3–18 years, respectively. Main outcome measures : Annual inpatient and outpatient insurance claims and costs (2019 USD) for cases versus controls. Results : Fifty-eight, 56, and 279 cases and controls comprised the infantile, child, and juvenile cohorts, respectively. Cases had more inpatient claims than controls (infantile: 60.3% vs 1.7%; child: 35.7% vs 3.6%; juvenile: 47.0% vs 4.3%; all P ≤ 0.002). Mean net payments for inpatient admissions were higher for cases versus controls (infantile: $118, 609.00 vs $58.79; child: $26, 940.01 vs $143.56; juvenile: $39, 389.91 vs $701.21; all P ≤ 0.01), as were mean net payments for outpatient services (infantile: $55, 537.83 vs $2, 047.20; child: $73, 093.66 vs $1, 307.56; juvenile: $49, 067.83 vs $1, 134.69; all P ≤ 0.0002). Conclusions : Direct costs of SMA are tremendous, often >50-fold higher compared with matched controls. Efforts are needed to reduce costs through improved standards of care.