Pnd109 Patient Perspectives on the Impact of Cervical Dystonia (Cd) and Botulinum Neurotoxin Type a (Bont-A) Treatment on Work

Abstract

Objectives: To understand the economic and humanistic burden attributed to myasthenia gravis (MG). Methods: We conducted a literature search (January 2009 to April 2019) in the biomedical database Embase (including Medline), focusing on English language observational studies and economic models evaluating patients with MG in the United States. Key search terms focused on costs, healthcare resource utilization, and quality of life (QoL). Results: A total of 18 studies were identified that included economic or humanistic burden data. Median length of hospitalization in patients with MG ranged from 2 days to 8 days, with costs per admission, using National Inpatient Sample data, ranging from a median of $16,000 in 1 study to a mean of nearly $99,000 in another analysis. Patient factors including MG crisis, presence of respiratory failure, and complex medication regimens (including multiple immunosuppressive and conventional therapies) worsened the burden, increasing length of stay from a median of 4 -6 days to 6 -10 days. Costs of admission increased from $16,000 to $26,600 for patients hospitalized for MG (not MG crisis), up to almost $54,000 for patients experiencing an MG crisis and receiving plasma exchange. Among patients treated with multiple immunosuppressants, presence of continued functional disability contributed to a worse QoL. One study found that QoL was worse in women than men, but the difference was eliminated for women who had undergone a thymectomy. Conclusions: The economic and humanistic burden associated with MG is considerable, particularly for patients with severe complications, including MG crisis. Understanding the risk factors associated with MG-related complications, and the potential impact on treatment modalities, is crucial to improve the medical management of these patients. Additionally, there is a clear unmet need in this patient population for new treatment options to improve disease course and prevent complications.