Cost-Effectiveness Model Results of Intrathecal Baclofen Therapy Compared to Conventional Medical Management in Patients with Non-Focal Disabling Spasticity Who are Resistant or Intolerant to Oral Therapy at the Institut Guttmann

Abstract

A399Objectives: Health care resource utilization and costs were evaluated for patients diagnosed with multiple sclerosis (MS) in the U. S. Medicaid program. MethOds: Patients diagnosed with MS (International Classification of Disease, 9 th Revision, Clinical Modification [ICD-9-CM] diagnosis code 340) were identified using Medicaid data from 01JAN2008 through 31DEC2010. The initial diagnosis date was designated as the index date. Patients of the same age, race, and gender but without an MS diagnosis were identified and matched as the comparison cohort, with a randomly chosen index date to minimize selection bias. Patients in both groups were required to be at least age 18 years, and have continuous medical and pharmacy benefits 1 year before and 1 year post-index date. One-to-one propensity score matching (PSM) was used to compare health care costs and utilizations during the follow-up period, between the diseased and the comparison cohorts, and adjusted for baseline demographic and clinical characteristics. Results: After risk adjustment by PSM, a total of 14,179 patients in each cohort were matched. Significantly more MS patients had inpatient admissions (23.75% vs. 10.87%, p< 0.0001) and long-term care (22.64% vs. 4.13%, p< 0.0001), other service (99.70% vs. 89.00%, p< 0.0001) and pharmacy visits (73.08% vs. 67.71%, p< 0.0001) compared to those without an MS diagnosis. Higher health care utilization by MS patients led to significantly higher inpatient ($1,688 vs. $725, p< 0.0001), long-term care ($14,189 vs. $2,778, p< 0.0001), other service visit ($22,981 vs. $9,977, p< 0.0001) and pharmacy costs ($5,284 vs. $1,785, p< 0.0001) compared to those without MS. cOnclusiOns: Compared to patients in the comparator cohort, MS patients in the Medicaid program incurred substantially higher health care resource utilization and costs.

Early outcomes after intrathecal baclofen therapy in ambulatory patients with multiple sclerosis

“…There are several studies that show increased cost-effectiveness with ITB therapy. 23,24 We recognize that there are several limitations in this study, most importantly that the data were collected retrospectively and were at times incomplete. Moreover, there is always a risk of introducing an unintended bias due to the nature of retrospective studies.…”

Estado del Arte en Neurotecnologías para la Asistencia y la Rehabilitación en España: Tecnologías Fundamentales

“…Entre ellos destacan sistemas de infusión continua intratecal de fármacos para tratar espasticidad (Vidal et al, 2000Guillaume et al, 2005;Slof et al, 2014), implante para manejo de la vejiga y el intestino neurógeno, sistema SARS (Sacral Anterior Root Stimulator) (Sarrias et al, 1993;Borau Duran, 2004), y estimulación del nervio dorsal genital para la hiperactividad del detrusor en la vejiga neurógena (Opisso et al, 2011(Opisso et al, , 2013.…”