Neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein-antibody associated disease (MOGAD) are associated with a high financial burden, and that burden impacts QOL for patients with either condition, according to findings published in Neurology.
For the multicenter, cross-sectional study, researchers examined costs and HRQOL associated with NMOSD and MOGAD. They obtained data on consumption of medical and non-medical resources and patients’ ability to work using patient questionnaires. The analysis included 212 patients, most of whom (80%) were women. The median patient age was 50, the median disease duration was 7 years, and the median Expanded Disability Status Scale (EDSS) score was 3.5.
Mean Total Cost of Illness
The mean total annual cost of illness (COI) per patient was estimated to be $70,297 (95% CI, $60,445 to $80,586). The greatest proportion of this COI, at 43%, was related to direct medical costs, including outpatient consultations, inpatient hospital care, medications, and medical aids. Direct non-medical costs accounted for 34% of the total COI and included transportation and investments in one’s home. Indirect costs accounted for the lowest proportion of the total COI, at 23%, and included loss of salary for both the employed and the unemployed.
Annual costs rose in conjunction with increasing EDSS, according to the study results, with the most notable increase in costs for informal care. Total annual COI did not differ between serogroups. Additionally, the individual cost categories between serogroups were not different except for the cost related to outpatient diagnostic tests, which were significantly different (P=0.01) between AQP4-antibody positive NMOSD and MOGAD.
Minor to Severe HRQOL Problems
More than two-thirds of patients reported minor to severe problems with the following HRQOL dimensions: pain/discomfort (N=168; 79%); usual activities (N=146; 69%); mobility (N=142; 67%); and anxiety/depression (N=132; 62%). More than a third of patients (35%) noted a detriment in self-care. In all five dimensions of HRQOL that were examined, the problems showed a positive correlation with EDSS: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
The study results provide evidence for the use of an early, individually tailored, and cost-effective therapy to stop long-term disability and maintain quality of life for patients with NMOSD and MOGAD, according to the investigators.