Healthcare utilization and costs associated with autologous haematopoietic stem cell transplantation in Norwegian patients with relapsing remitting multiple sclerosis

• Published in: Multiple sclerosis and related disorders Vol. 84; p. 105507
• Main Authors: Gottschlich, Katharina Natalie, Zolic-Karlsson, Zinajda, Aas, Eline, Kvistad, Silje Agnethe Stokke, Bø, Lars, Torkildsen, Øivind, Lehmann, Anne Kristine
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.04.2024
• Subjects: Haematopoietic stem cell transplantation; Healthcare costs; Hematopoietic Stem Cell Transplantation - methods; Humans; Micro costing analysis; Multiple Sclerosis - therapy; Multiple Sclerosis, Relapsing-Remitting - drug therapy; Patient Acceptance of Health Care; Quality of Life; Relapsing remitting multiple sclerosis; Treatment Outcome; Healthcare costs; Micro costing analysis; D24; I1; Haematopoietic stem cell transplantation; H4; Relapsing remitting multiple sclerosis
• ISSN: 2211-0348; 2211-0356
• DOI: 10.1016/j.msard.2024.105507

What is already known about the topic?•Autologous hematopoietic stem cell transplantation (AHSCT) is a highly effective therapy for relapsing remitting MS (RRMS).•Few studies have investigated costs of AHSCT in this patient population.What does the paper add to existing knowledge?•The first micro-costing study estimating healthcare utilization and costs associated with AHSCT in Norwegian RRMS patients.•Patient-level data extracted from medical journals of 30 RRMS patients receiving AHSCT treatment in the period from January 2015 to January 2018.What insights does the paper provide for informing healthcare-related decision making?•Average total healthcare cost of AHSCT for RRMS patients estimated to EUR 66 304 (95 % CI: EUR 63 598 – EUR 69 010) in a one year perspective.•This study presents relevant methods for estimating healthcare costs associated with AHSCT, which may be of value for an upcoming cost-effectiveness evaluations.•Long-term healthcare cost savings may be achieved using AHSCT in selected patients with aggressive RRMS. This is due to the high costs of most used disease modifying treatments which varies from 20 000 to 30 000 EUR per year. Multiple sclerosis (MS) patients experience long-term deterioration of neurological function, reduced quality of life, long-lasting treatment cycles, and an increased risk of early workability loss imposing an economic burden to society. Autologous haematopoietic stem cell transplantation (AHSCT) has shown promising treatment effects for relapsing remitting MS (RRMS). This study employs a micro-costing approach to estimate healthcare utilization and costs associated with AHSCT in Norwegian RRMS patients. Patient-level data were extracted from medical journals of 30 RRMS patients receiving AHSCT treatment at Haukeland University Hospital in the period from January 2015 to January 2018. The time horizon for the analysis was from the pretransplant screening until one year after AHSCT. A correlation was found between patient body weight and total healthcare cost. The average total healthcare cost of AHSCT for RRMS patients was estimated to EUR 66 304 (95% CI: EUR 63 598 – EUR 69 010) including costs associated with the pre-AHSCT period, AHSCT treatment phases and one-year follow-up. The majority of the costs, EUR 64 329, occurred during the treatment phase and within the first 100 days after AHSCT. The results indicate that long-term healthcare cost savings may be achieved using AHSCT in selected patients with aggressive RRMS. This is due to the high costs of most used disease modifying treatments. Further research including long-term clinical data is needed to determine the cost-effectiveness of this treatment.