The Impact of HSCT on Treatment Cost of Multiple Sclerosis: Real-World Study

[ActiveMSers]

Brief Report

Impact of Immunoablation and Autologous Hematopoietic Stem Cell Transplantation (AHSCT) on Treatment Cost of Multiple Sclerosis: Real-World Nationwide Study

KatarzynaOrlewskaMD¹KrzysztofBoguszMD¹AleksandraPodlecka-PiętowskaMD, PhD²MonikaNojszewskaMD, PhD²MirosławMarkiewicz(Professor)³RobertLiwochMD, PhD⁴PawelOrlewskiMSc⁵AndrzejŚliwczyńskiMSc, PhD⁶BeataZakrzewska-Pniewska(Professor)²EmilianSnarskiMD, PhD¹

https://doi.org/10.1016/j.vhri.2020.10.008

Highlights

•The autologous hematopoietic stem cell transplantation (AHSCT) has been acknowledged as novel standard treatment in aggressive multiple sclerosis (MS); however, little is known of potential real-life impact on treatment costs.
•A real-life nationwide analysis of medical costs before and after AHSCT of patients with MS who underwent this treatment is provided.
•Massive reduction of treatment cost following AHSCT is observed in patients with MS.

Abstract

Objectives
To provide real-world data on the impact of autologous hematopoietic stem cell transplantation (AHSCT) on treatment costs of patients with multiple sclerosis (MS) in Poland.

Methods
Medical data of 105 patients who underwent AHSCT in the years 2011 to 2016 were obtained from the National Health Fund (NHF) database. Treatment costs were calculated from the public payer’s perspective per patient-year for the total available period as well as 12 months before and after AHSCT. The statistical analysis was performed using MATLAB 2016b.

Results
Mean treatment-related costs covered by the NHF per patient-year before and after the transplantation were €4314.9 and €1188.8 , respectively. The average cost of disease-modifying drugs per patient was reduced from €2497.9/year before to €65.3/year after AHSCT.

Conclusions
Although the initial cost of AHSCT is high, the costs involving AHSCT and post-AHSCT treatment could, according to our analysis, pay off in 3.9 years, when compared to the costs of disease-modifying drug therapy in aggressive MS. The study provides evidence that the AHSCT can lead to significant savings in treatment costs of aggressive MS from the public payer’s perspective.