A multicentre study of the hospital care of 1500 patients with myelomeningocele

Muñoz, M Bea; Llopis, Inés; Agulló, E. Martínez; López, Antonio José Mezcua; Aymerich, V García; Valero, José

doi:10.1038/sc.1994.88

Cited by 6 publications

(9 citation statements)

References 8 publications

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“…In Spain, the Social Security system spent direct medical costs of €3,825,037 ($2,953,138 in 1988$) per year for the care of patients with spina bifida [3], representing approximately €3,541 ($2,734 in 1988$) per person per year.…”

Section: Resultsmentioning

confidence: 99%

Economic burden of neural tube defects and impact of prevention with folic acid: a literature review

Yi¹,

et al. 2011

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Neural tube defects (NTDs) are the second most common group of serious birth defects. Although folic acid has been shown to reduce effectively the risk of NTDs and measures have been taken to increase the awareness, knowledge, and consumption of folic acid, the full potential of folic acid to reduce the risk of NTDs has not been realized in most countries. To understand the economic burden of NTDs and the economic impact of preventing NTDs with folic acid, a systematic review was performed on relevant studies. A total of 14 cost of illness studies and 10 economic evaluations on prevention of NTDs with folic acid were identified. Consistent findings were reported across all of the cost of illness studies. The lifetime direct medical cost for patients with NTDs is significant, with the majority of cost being for inpatient care, for treatment at initial diagnosis in childhood, and for comorbidities in adult life. The lifetime indirect cost for patients with spina bifida is even greater due to increased morbidity and premature mortality. Caregiver time costs are also significant. The results from the economic evaluations demonstrate that folic acid fortification in food and preconception folic acid consumption are cost-effective ways to reduce the incidence and prevalence of NTDs. This review highlights the significant cost burden that NTDs pose to healthcare systems, various healthcare payers, and society and concludes that the benefits of prevention of NTDs with folic acid far outweigh the cost. Further intervention with folic acid is justified in countries where the full potential of folic acid to reduce the risk of NTDs has not been realized.

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Section: Resultsmentioning

confidence: 99%

Economic burden of neural tube defects and impact of prevention with folic acid: a literature review

Yi¹,

et al. 2011

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“… 28 The cost of admission for MMC patients has also been reported in a Spanish study. 32 The cost of MMC repair in hospital was also reported in other studies. 31 , 33 …”

Section: Resultsmentioning

confidence: 53%

“… Healthcare system Healthcare system ICER/QALY/DALY Fetoscopic MMC surgical approach was cost-effective with an ICER of $1029/QALY ICER= $4273/QALY gained (at the minimal postnatal repair cost of $5882). ICER=$35,531/QALY gained (at the maximum prenatal repair cost of $75,787) VPS had an ICER of $76,620.32 vs ETV/CPC with an ICER of $112,762.44 N.R N.R N.R N.R No 8 9 10 11 12 13 Reference Kshettry et al, 2014 31 Bea et al, 1994 32 Hubbard et al, 2019 33 Liptak et al, 1985 24 Cartwright et al, 2019 34 Werner et al, 2012 35 Country USA Spain Haiti USA USA USA Year of Publication 2014 1994 2019 1985 2019 2012 Study Type Cost description analysis Cost description analysis Cost description analysis Cost description analysis Cost effectiveness Cost effectiveness Population 860 MMC surgical cases 1500 MMC patients 38 MMC patients …”

Section: Resultsmentioning

confidence: 99%

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Pharmacoeconomic Evaluation of Costs of Myelomeningocele and Meningocele Treatment and Screening

Hoxha,

Malaj,

Zappacosta

et al. 2024

CEOR

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Background The prevention of myelomeningocele (MMC) and meningocele (MC) is a public health concern. A systematic review on economic factors associated with MMC and MC can help the policy makers to evaluate the cost-effectiveness of screening and treatment. To our knowledge, this is the first systematic review to provide up-to date pharmacoeconomic evidence of all economic studies present in literature on different aspects of MMC and MC. Methods We searched in the National Health Service Economic Evaluation Database (NHSEED), PubMed, Cost-effectiveness Analysis Registry (CEA Registry), Centre for Reviews and Dissemination (CRD), Health Technology Assessment Database (HTAD), Cochrane Library, and Econlit. The PRISMA guidelines were followed in the search and evaluation of literature. Only articles in English not limited by the year of publication that fulfilled the eligibility criteria were included in this systematic review. Results Nineteen papers were included in the study. The studies were very heterogeneous and reported a comparison of the costs between prenatal versus postnatal repair, the cost of fetoscopic approach versus open surgery, the cost of ventriculoperitoneal shunting (VPS) versus endoscopic third ventriculostomy (ETV), and ETV with choroid plexus cauterization (ETV/CPC), the cost of hospitalization, and the cost of diagnosis for MMC. Conclusion The results of this study can help in implementing new policies in different countries to assist MC and MMC patients with the cost of treatment and screening.

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“…There is a growing adult spina bifida population, with 75–85% of children with spina bifida expected to survive into adulthood with advances in their care [ 1 , 2 , 3 ]. Bladder disturbances are common in spina bifida patients, affecting 24–98% of patients [ 3 – 7 ]. Without adequate urological management, the upper urinary tract can be adversely affected; as many as 48% of spina bifida patients with untreated urologic problems have evidence of kidney damage [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

A snapshot of the adult spina bifida patient – high incidence of urologic procedures

Liu

Greiman

Casey

et al. 2016

CEJU

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IntroductionTo describe the urologic outcomes of contemporary adult spina bifida patients managed in a multidisciplinary clinic.Material and methodsA retrospective chart review of patients seen in our adult spina bifida clinic from January 2004 to November 2011 was performed to identify urologic management, urologic surgeries, and co-morbidities.Results225 patients were identified (57.8% female, 42.2% male). Current median age was 30 years (IQR 27, 36) with a median age at first visit of 25 years (IQR 22, 30). The majority (70.7%) utilized clean intermittent catheterization, and 111 patients (49.3%) were prescribed anticholinergic medications. 65.8% had urodynamics performed at least once, and 56% obtained appropriate upper tract imaging at least every other year while under our care. 101 patients (44.9%) underwent at least one urologic surgical procedure during their lifetime, with a total of 191 procedures being performed, of which stone procedures (n = 51, 26.7%) were the most common. Other common procedures included continence procedures (n = 35, 18.3%) and augmentation cystoplasty (n = 29, 15.2%). Only 3.6% had a documented diagnosis of chronic kidney disease and 0.9% with end-stage renal disease.ConclusionsMost adult spina bifida patient continue on anticholinergic medications and clean intermittent catheterization. A large percentage of patients required urologic procedures in adulthood. Patients should be encouraged to utilize conservative and effective bladder management strategies to reduce their risk of renal compromise.

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A multicentre study of the hospital care of 1500 patients with myelomeningocele

Cited by 6 publications

References 8 publications

Economic burden of neural tube defects and impact of prevention with folic acid: a literature review

Economic burden of neural tube defects and impact of prevention with folic acid: a literature review

Pharmacoeconomic Evaluation of Costs of Myelomeningocele and Meningocele Treatment and Screening

A snapshot of the adult spina bifida patient – high incidence of urologic procedures

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