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Grand TS, Ren S, Hall J, Åström DO, Regnier S, Thokala P. Issues, Challenges and Opportunities for Economic Evaluations of Orphan Drugs in Rare Diseases: An Umbrella Review. PHARMACOECONOMICS 2024; 42:619-631. [PMID: 38616217 PMCID: PMC11126517 DOI: 10.1007/s40273-024-01370-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/03/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND AND OBJECTIVES There are significant challenges when obtaining clinical and economic evidence for health technology assessments of rare diseases. Many of them have been highlighted in previous systematic reviews but they have not been summarised in a comprehensive manner. For all stakeholders working with rare diseases, it is important to be aware and understand these issues. The objective of this review is to identify the main challenges for the economic evaluation of orphan drugs in rare diseases. METHODS An umbrella review of systematic reviews of economic studies concerned with orphan and ultra-orphan drugs was conducted. Studies that were not systematic reviews, or on advanced therapeutic medicinal products, personalised medicines or other interventions that were not considered orphan drugs were excluded. The database searches included publications from 2010 to 2023, and were conducted in MEDLINE, EMBASE and the Cochrane library using filters for systematic reviews, and economic evaluations and models. These filters were combined with search terms for rare diseases and orphan drugs. A hand search supplemented the literature searches. The findings were reported by a compliant Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. RESULTS Two hundred and eighty-two records were identified from the literature searches, of which 64 were duplicates, whereas five reviews were identified from the hand search. A total of 36 reviews were included after screening against inclusion/exclusion criteria, 35 from literature searches and one from hand searching. Of those studies 1, 27 and 8 were low, moderate and high quality, respectively. The reviews highlight the scarcity of evidence for health economic parameters, for example, clinical effectiveness, costs, quality of life and the natural history of disease. Health economic evaluations such as cost-effectiveness and budget-impact analyses were scarce, and generally low-to-moderate quality. The causes were limited health economic parameters, together with publications bias, especially for cost-effectiveness analyses. CONCLUSIONS The results highlighted issues around a considerable paucity of evidence for economic evaluations and few cost-effectiveness analyses, supporting the notion that a paucity of evidence makes economic evaluations of rare diseases more challenging compared with more prevalent diseases. Furthermore, we provide recommendations for more sustainable approaches in economic evaluations of rare diseases.
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Affiliation(s)
- Tobias Sydendal Grand
- Sheffield Centre for Health and Related Research (SCHARR), University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK.
- Lundbeck A/S, Copenhagen, Denmark.
| | - Shijie Ren
- Sheffield Centre for Health and Related Research (SCHARR), University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK
| | - James Hall
- Institute of Applied Health Research, Health Economics Unit, University of Birmingham, Edgbaston, Birmingham, UK
| | | | | | - Praveen Thokala
- Sheffield Centre for Health and Related Research (SCHARR), University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK
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Lorenzoni V, Marinello D, Palla I, Mosca M, Turchetti G, Talarico R. A cost-of-illness study of Behçet syndrome in Italy. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024; 25:411-422. [PMID: 37212892 PMCID: PMC10973046 DOI: 10.1007/s10198-023-01593-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 04/21/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVE This study aims at evaluating the cost-of-illness (COI) of patients diagnosed with Behcet's syndrome (BS) in Italy, trying to depict the impact of different costs' components to the overall economic burden and analysing the variability of costs according to years since diagnosis and age at first symptoms. METHODS With a cross-sectional evaluation, we surveyed a large sample of BS patients in Italy assessing several dimensions related to BS, also including fact related to the use of health resources utilization, formal and informal care, and productivity losses. Overall costs, direct health, direct non-health, and indirect costs were thus estimated per patient/year considering a Societal perspective and the impact of years since diagnosis, age at first symptoms on costs was evaluated using generalized linear model (GLM) and a two-part model, adjusting for age and distinguishing among employed and non-employed responders. RESULTS A total of 207 patients were considered in the present study. From the perspective of the Society, mean overall costs for BS patient were estimated to be 21,624 € (0;193,617) per patient/year. Direct non-health expenses were the main costs component accounting for 58% of the overall costs, followed direct health costs, 36%, while indirect costs because of productivity losses represented 6% of the overall costs. Being employed resulted in significantly lower overall costs (p = 0.006). Results from the multivariate regression analyses suggested that the probability of incurring in overall costs equal to zero decreased as time from BS diagnosis is 1 year or more as compared to newly diagnosed patients (p < 0.001); while among those incurring in expenses, costs decreased for those experiencing first symptoms between 21 and 30 years (p = 0.027) or later (p = 0.032) as compared to those having symptoms earlier. Similar findings emerged among the subgroups of patients declaring themselves as workers, while no impact of years since diagnosis or age of first symptoms was found among non-workers. CONCLUSIONS The present study offers a comprehensive overview of the economic consequences imposed by BS in a societal perspective, providing insights into the distribution of the different costs component related to BS, thus helping the development of targeted policies.
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Affiliation(s)
- Valentina Lorenzoni
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri Della Libertà n. 33, 56127, Pisa, Italy.
| | - Diana Marinello
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Ilaria Palla
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri Della Libertà n. 33, 56127, Pisa, Italy
| | - Marta Mosca
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Giuseppe Turchetti
- Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri Della Libertà n. 33, 56127, Pisa, Italy
| | - Rosaria Talarico
- Rheumatology Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
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Nakhaee M, Khandehroo M, Esmaeili R. Cost of illness studies in COVID-19: a scoping review. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2024; 22:3. [PMID: 38238797 PMCID: PMC10797972 DOI: 10.1186/s12962-024-00514-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 01/10/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Human communities suffered a vast socioeconomic burden in dealing with the pandemic of coronavirus disease 2019 (COVID-19) globally. Real-word data about these burdens can inform governments about evidence-based resource allocation and prioritization. The aim of this scoping review was to map the cost-of-illness (CoI) studies associated with COVID-19. METHODS This scoping review was conducted from January 2019 to December 2021. We searched cost-of-illness papers published in English within Web of Sciences, PubMed, Google Scholar, Scopus, Science Direct and ProQuest. For each eligible study, extracted data included country, publication year, study period, study design, epidemiological approach, costing method, cost type, cost identification, sensitivity analysis, estimated unit cost and national burden. All of the analyses were applied in Excel software. RESULTS 2352 records were found after the search strategy application, finally 28 articles met the inclusion criteria and were included in the review. Most of the studies were done in the United States, Turkey, and China. The prevalence-based approach was the most common in the studies, and most of studies also used Hospital Information System data (HIS). There were noticeable differences in the costing methods and the cost identification. The average cost of hospitalization per patient per day ranged from 101$ in Turkey to 2,364$ in the United States. Among the studies, 82.1% estimated particularly direct medical costs, 3.6% only indirect costs, and 14.3% both direct and indirect costs. CONCLUSION The economic burden of COVID-19 varies from country to country. The majority of CoI studies estimated direct medical costs associated with COVID-19 and there is a paucity of evidence for direct non-medical, indirect, and intangible costs, which we recommend for future studies. To create homogeneity in CoI studies, we suggest researchers follow a conceptual framework and critical appraisal checklist of cost-of-illness (CoI) studies.
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Affiliation(s)
- Majid Nakhaee
- Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Masoud Khandehroo
- Department of Community Medicine, School of Medicine, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Reza Esmaeili
- Department of Public Health, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Imam Khomeini Avenue, Gonabad, Khorasan, 9691793718, Iran.
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Senn KC, Thiele S, Kummer K, Walter MC, Nagels KH. Cost of illness in inclusion body myositis: results from a cross-sectional study in Germany. Orphanet J Rare Dis 2023; 18:337. [PMID: 37880781 PMCID: PMC10601274 DOI: 10.1186/s13023-023-02902-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 08/31/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Inclusion body myositis (IBM) is the most frequent type of myositis in elder patients with a slow chronic progression and refractory to treatment. Previous cost of illness (COI) studies in IBM used claims data to estimate direct costs in the US. No evidence exists globally on both direct and indirect costs in IBM from a societal perspective. We conducted a survey in patients registered in the German IBM patient registry. Self-developed items were used to assess the utilized healthcare resources and estimate the cost. The German Self-Administered Comorbidity Questionnaire (SCQ-D), the sIBM Physical Functioning Assessment (sIFA) and patient-reported measures for satisfaction and improvements in healthcare were applied for an explorative analysis. RESULTS In total, 82 patients completed the survey. We estimated the mean total annual per capita COI of US$102,682 (95% CI US$82,763-US$123,090) in 2021. 92.7% of the total COI were direct costs. Medical costs were similar to nonmedical costs, with substantial costs for pharmacotherapy and informal care. Depending on the prevalence estimate, the total national COI per year were US$42.7 million-US$213.7 million. Significant differences in total COI were identified for the degree of disability, marital and employment status (p < 0.05). CONCLUSIONS We identified remarkable and heterogenous cost in IBM. As informal care costs represented the most relevant cost driver, caregiver burden is a major factor in the patient journey. For the first time, comprehensive economic potentials were identified as a basis to improve the actual care situations and prioritizing future activities for research, pharmaceutical and digital product development as well as health politics.
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Affiliation(s)
- Katja C Senn
- Chair of Healthcare Management and Health Services Research, University of Bayreuth, Parsifalstrasse 25, 95445, Bayreuth, Germany
| | - Simone Thiele
- Department of Neurology, Friedrich Baur Institute, LMU University Hospital, LMU Munich, Ziemssenstrasse 1, 80336, Munich, Germany
| | - Karsten Kummer
- Department of Neurology, University Medical Center Goettingen, 37075, Göttingen, Germany
| | - Maggie C Walter
- Department of Neurology, Friedrich Baur Institute, LMU University Hospital, LMU Munich, Ziemssenstrasse 1, 80336, Munich, Germany
| | - Klaus H Nagels
- Chair of Healthcare Management and Health Services Research, University of Bayreuth, Parsifalstrasse 25, 95445, Bayreuth, Germany.
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Adachi T, El-Hattab AW, Jain R, Nogales Crespo KA, Quirland Lazo CI, Scarpa M, Summar M, Wattanasirichaigoon D. Enhancing Equitable Access to Rare Disease Diagnosis and Treatment around the World: A Review of Evidence, Policies, and Challenges. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4732. [PMID: 36981643 PMCID: PMC10049067 DOI: 10.3390/ijerph20064732] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/23/2023] [Accepted: 02/26/2023] [Indexed: 06/18/2023]
Abstract
This document provides a comprehensive summary of evidence on the current situation of rare diseases (RDs) globally and regionally, including conditions, practices, policies, and regulations, as well as the challenges and barriers faced by RD patients, their families, and caregivers. The document builds on a review of academic literature and policies and a process of validation and feedback by a group of seven experts from across the globe. Panelists were selected based on their academic merit, expertise, and knowledge regarding the RD environment. The document is divided into five main sections: (1) methodology and objective; (2) background and context; (3) overview of the current situation and key challenges related to RDs covering six dimensions: burden of disease, patient journey, social impact, disease management, RD-related policies, and research and development; (4) recommendations; and (5) conclusions. The recommendations are derived from the discussion undertaken by the experts on the findings of this review and provide a set of actionable solutions to the challenges and barriers to improving access to RD diagnosis and treatment around the world. The recommendations can support critical decision-making, guiding efforts by a broad range of RDs stakeholders, including governments, international organizations, manufacturers, researchers, and patient advocacy groups.
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Affiliation(s)
- Takeya Adachi
- Department of Dermatology, Keio University School of Medicine, Tokyo 160-8582, Japan
- Department of Medical Regulatory Science, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- United Japanese-Researchers Around-the-World (UJA), Isehara 259-1143, Japan
| | - Ayman W. El-Hattab
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
- MENA (Middle East and North Africa) Organization for Rare Diseases, Dubai 500767, United Arab Emirates
- Department of Pediatrics, University Hospital Sharjah, Sharjah 72772, United Arab Emirates
| | - Ritu Jain
- Dystrophic Epidermolysis Bullosa Research Association (DEBRA), Singapore 059811, Singapore
- Asia Pacific Alliance of Rare Disease Organizations (APARDO), Singapore 188976, Singapore
- Language and Communication Centre, School of Humanities and Social Sciences, Nanyang Technological University, Singapore 639798, Singapore
| | | | - Camila I. Quirland Lazo
- Health Technology Assessment Unit, Cancer Research Department, Arturo López Perez Foundation, Santiago 7500921, Chile
- School of Medicine, Universitat Autònoma de Barcelona, 080193 Barcelona, Spain
- Faculty of Pharmaceutical and Chemical Sciences, University of Chile, Santiago 8380000, Chile
| | - Maurizio Scarpa
- European Reference Network for Hereditary Metabolic Diseases (MetabERN), 33100 Udine, Italy
- Regional Coordinating Center for Rare Diseases Friuli Venezia Giulia, Udine University Hospital, 33100 Udine, Italy
- Brains for Brain Foundation, 35128 Padova, Italy
| | - Marshall Summar
- The Translational Science Training Program, National Institutes of Health (NIH), Maryland, MD 20814, USA
- Children’s National Medical Centre, Washington, DC 20010, USA
- National Organization for Rare Disorders (NORD), Quincy, MA 02169, USA
- Children’s National Rare Disease Institute, Washington, DC 20012, USA
- Department of Pediatrics, George Washington University, Washington, DC 20052, USA
| | - Duangrurdee Wattanasirichaigoon
- Thai Rare Disease Foundation (ThaiRDF), Bangkok 10230, Thailand
- Prader-Willi Syndrome Association (PWSA) of Thailand, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
- Rare Disease Working Committee, Thai National Health Security Office (NHSO), Bangkok 10210, Thailand
- Sub-Working Committee for Rare Disease Medicine, Thailand National List of Essential Medicines (NLEM), National Drug Policy Division, Food and Drug Administration, Nonthaburi 11000, Thailand
- Medical Genetics Network, Genetics Society of Thailand, Bangkok 10330, Thailand
- Thailand Medical Genetics and Genomics Association (TMGGA), Bangkok 10510, Thailand
- Asia Pacific Society of Human Genetics (APSHG), Singapore 229899, Singapore
- Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
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Chung CC, Ng NY, Ng YN, Lui AC, Fung JL, Chan MC, Wong WH, Lee SL, Knapp M, Chung BH. Socio-economic costs of rare diseases and the risk of financial hardship: a cross-sectional study. THE LANCET REGIONAL HEALTH - WESTERN PACIFIC 2023. [DOI: 10.1016/j.lanwpc.2023.100711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Has C, Hess M, Anemüller W, Blume-Peytavi U, Emmert S, Fölster-Holst R, Frank J, Giehl K, Günther C, Hammersen J, Hillmann K, Höflein B, Hoeger PH, Hotz A, Mai TA, Oji V, Schneider H, Süßmuth K, Tantcheva-Póor I, Thielking F, Zirn B, Fischer J, Reimer-Taschenbrecker A. Epidemiology of inherited epidermolysis bullosa in Germany. J Eur Acad Dermatol Venereol 2023; 37:402-410. [PMID: 36196047 DOI: 10.1111/jdv.18637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/17/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Epidermolysis bullosa (EB) is a rare genetic disorder manifesting with skin and mucosal membrane blistering in different degrees of severity. OBJECTIVE Epidemiological data from different countries have been published, but none are available from Germany. METHODS In this population-based cross-sectional study, people living with EB in Germany were identified using the following sources: academic hospitals, diagnostic laboratories and patient organization. RESULTS Our study indicates an overall EB incidence of 45 per million live births in Germany. With 14.23 per million live births for junctional EB, the incidence is higher than in other countries, possibly reflecting the availability of early molecular genetic diagnostics in severely affected neonates. Dystrophic EB was assessed at 15.58 cases per million live births. The relatively low incidence found for EB simplex, 14.93 per million live births, could be explained by late or missed diagnosis, but also by 33% of cases remaining not otherwise specified. Using log-linear models, we estimated a prevalence of 54 per million for all EB types, 2.44 for junctional EB, 12.16 for dystrophic EB and 28.44 per million for EB simplex. These figures are comparable to previously reported data from other countries. CONCLUSIONS Altogether, there are at least 2000 patients with EB in the German population. These results should support national policies and pharmaceutical companies in decision-making, allow more precise planning of drug development and clinical trials, and aid patient advocacy groups in their effort to improve quality of life of people with this orphan disease.
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Affiliation(s)
- Cristina Has
- Department of Dermatology, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany
| | - Moritz Hess
- Medical Faculty and Medical Center, Institute of Medical Biometry and Statistics, University of Freiburg, Freiburg, Germany
| | | | - Ulrike Blume-Peytavi
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Steffen Emmert
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Regina Fölster-Holst
- Department of Dermatology, Venereology and Allergology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Jorge Frank
- Department of Dermatology, Venereology and Allergology, University Hospital Göttingen, Göttingen, Germany
| | - Kathrin Giehl
- Department of Dermatology and Allergy, University of Munich LMU, Munich, Germany
| | - Claudia Günther
- Department of Dermatology, University Hospital, Technical University Dresden, Dresden, Germany
| | - Johanna Hammersen
- Department of Pediatrics, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Kathrin Hillmann
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Bettina Höflein
- "Interessengemeinschaft Epidermolysis bullosa (IEB) e.V. Debra Deutschland", Biedenkopf, Germany
| | - Peter H Hoeger
- Fachbereich Pädiatrie und Pädiatrische Dermatologie/Allergologie, Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg, Germany
| | - Alrun Hotz
- Medical Faculty and Medical Center, Institute of Human Genetics, University of Freiburg, Freiburg, Germany
| | - Thuy Anh Mai
- Fachbereich Pädiatrie und Pädiatrische Dermatologie/Allergologie, Katholisches Kinderkrankenhaus Wilhelmstift, Hamburg, Germany
| | - Vinzenz Oji
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - Holm Schneider
- Department of Pediatrics, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Kira Süßmuth
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | | | - Frederieke Thielking
- Department of Dermatology, Venereology and Allergology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Birgit Zirn
- Genetikum® Stuttgart, Genetic Counselling and Diagnostics, Stuttgart, Germany
| | - Judith Fischer
- Medical Faculty and Medical Center, Institute of Human Genetics, University of Freiburg, Freiburg, Germany
| | - Antonia Reimer-Taschenbrecker
- Department of Dermatology, Medical Faculty and Medical Center, University of Freiburg, Freiburg, Germany.,Department of Dermatology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA
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Hartmanis SL, Baker EK, Godler DE, Liew D. Estimating the impact of Angelman syndrome on parental productivity in Australia using productivity-adjusted life years. Disabil Health J 2022; 16:101423. [PMID: 36639256 DOI: 10.1016/j.dhjo.2022.101423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/18/2022] [Accepted: 11/27/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Angelman syndrome (AS) is a rare genetic condition characterized by global developmental delay, including severe intellectual disability. The parents of persons with AS experience increased stress, anxiety, and depression. This impacts parents' career choices and productivity. OBJECTIVE To estimate, for the first time, the total productivity lost by the parents of persons with AS over a 10-year period in Australia and the corresponding cost to society. METHODS A cost-of-illness model with simulated follow-up over a 10-year period was developed, with 2019 as the baseline year, facilitated by a Markov chain of life tables. The prevalence of persons with AS and their parents, the productivity-adjusted life years (PALYs) lost by parents, and the cost to society were estimated. Key data were obtained from a prospective cohort of AS families, peer-reviewed literature, and publicly available sources. RESULTS The base-case productivity burden borne by the estimated 330 living parents of the 428 prevalent persons with AS totaled AUD$45.30 million, corresponding to a loss of 38.42% of PALYs per parent. CONCLUSIONS Caring for a child with AS has a significant impact on the productivity of affected parents, with a large associated impact on the broader Australian economy.
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Affiliation(s)
- Sally L Hartmanis
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia.
| | - Emma K Baker
- Diagnosis and Development, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria, 3052, Australia; Faculty of Medicine, Dentistry and Health Sciences, Department of Paediatrics, University of Melbourne, Parkville, Victoria, 3010, Australia; School of Psychology and Public Health, La Trobe University, Plenty Road and Kingsbury Drive, Bundoora, Victoria, 3086, Australia
| | - David E Godler
- Diagnosis and Development, Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria, 3052, Australia; Faculty of Medicine, Dentistry and Health Sciences, Department of Paediatrics, University of Melbourne, Parkville, Victoria, 3010, Australia
| | - Danny Liew
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
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Delaye J, Cacciatore P, Kole A. Valuing the "Burden" and Impact of Rare Diseases: A Scoping Review. Front Pharmacol 2022; 13:914338. [PMID: 35754469 PMCID: PMC9213803 DOI: 10.3389/fphar.2022.914338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/09/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction: Rare diseases (RDs) are a severe, chronic, degenerative and often life-threatening group of conditions affecting more than 30 million people in Europe. Their impact is often underreported and ranges from psychological and physical symptoms seriously compromising quality of life. There is then a need to consolidate knowledge on the economic, social, and quality of life impacts of rare diseases. Methods: This scoping review is the result of 9 qualitative interviews with experts and a literature search on Cost-of-Illness (COI) studies and quality of life (QoL) studies following the PRISMA methodology. Grey literature was also included to complement findings. Results. 63 COI studies were retrieved, covering 42 diseases and a vast majority of them using a prevalence-based approach (94%). All studies included medical costs, while 60% included non-medical costs, 68% productivity losses and 43% informal care costs. 56 studies on QoL were retrieved, mostly from Europe, with 30 different measurement tools. Grey literature included surveys from the pharmaceutical industry and patient organisations. Discussion: The majority of studies evaluating the impact of RDs on the individual and society use the COI approach, mostly from a societal perspective. Studies often vary in scope, making them difficult to consolidate or compare results. While medical costs and productivity losses are consistently included, QoL aspects are rarely considered in COI and are usually measured through generic tools. Conclusion: A comprehensive study on impact of rare disease across countries in Europe is lacking. Existing studies are heterogeneous in their scope and methodology and often lack a holistic picture of the impact of rare. Consensus on standards and methodology across countries and diseases is then needed. Studies that consider a holistic approach are often conducted by pharmaceutical companies and patient organisations exploring a specific disease area but are not necessarily visible in the literature and could benefit from the sharing of standards and best practices.
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Affiliation(s)
- Julien Delaye
- European Organisation for Rare Diseases (EURORDIS), Paris, France
| | | | - Anna Kole
- European Organisation for Rare Diseases (EURORDIS), Paris, France
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Zozaya N, Abdalla F, Casado Moreno I, Crespo-Diz C, Ramírez Gallardo AM, Rueda Soriano J, Alcalá Galán M, Hidalgo-Vega Á. The economic burden of pulmonary arterial hypertension in Spain. BMC Pulm Med 2022; 22:105. [PMID: 35346140 PMCID: PMC8962538 DOI: 10.1186/s12890-022-01906-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background Pulmonary Arterial Hypertension (PAH) is a rare, debilitating, and potentially fatal disease. This study aims to quantify the economic burden of PAH in Spain.
Methods The study was conducted from a societal perspective, including direct and indirect costs associated with incident and prevalent patients. Average annual costs per patient were estimated by multiplying the number of resources consumed by their unit cost, differentiating the functional class (FC) of the patient. Total annual costs per FC were also calculated, taking the 2020 prevalence and incidence ranges into account. An expert committee validated the information on resource consumption and provided primary information on pharmacological consumption. Unit costs were estimated using official tariffs and salaries in Spain. A deterministic sensitivity analysis was conducted to test the uncertainty of the model. Results The average annual total cost was estimated at €98,839 per prevalent patient (FC I-II: €65,233; FC III: €103,736; FC IV: €208,821), being €42,110 for incident patients (FC I-II: €25,666; FC III: €44,667; FC IV: €95,188). The total annual cost of PAH in Spain, taking into account a prevalence between 16.0 and 25.9 cases per million adult inhabitants (FC I-II 31.8%; FC III 61.3%; FC IV 6.9%) and an incidence of 3.7, was estimated at €67,891,405 to €106,131,626, depending on the prevalence considered. Direct healthcare costs accounted for 64% of the total cost, followed by indirect costs (24%), and direct non-healthcare costs (12%). The total costs associated with patients in FC I-II ranged between €14,161,651 and €22,193,954, while for patients in FC III costs ranged between €43,763,019 and €68,391,651, and for patients in FC IV between €9,966,735 and €15,546,021. In global terms, patients with the worst functional status (FC IV) account for only 6.9% of the adults suffering from PAH in Spain, but are responsible for 14.7% of the total costs. Conclusions PAH places a considerable economic burden on patients and their families, the healthcare system, and society as a whole. Efforts must be made to improve the health and management of these patients since the early stages of the disease. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01906-2.
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Affiliation(s)
- Néboa Zozaya
- Department of Health Economics, Weber, Calle Moreto, 17, 5º Dcha., 28014, Madrid, Spain. .,Department of Quantitative Methods in Economics and Management, University Las Palmas de Gran Canaria, Las Palmas, Spain.
| | - Fernando Abdalla
- Department of Health Economics, Weber, Calle Moreto, 17, 5º Dcha., 28014, Madrid, Spain
| | | | - Carlos Crespo-Diz
- Pharmacy Department, Complexo Hospitalario Universitario de Pontevedra, Instituto de Investigación Sanitaria Galicia Sur (IISGS), Pontevedra, Spain
| | | | - Joaquín Rueda Soriano
- Department of Cardiology, Hospital Universitari i Politècnic La Fe, Instituto de Investigación Sanitaria La Fe, CIBERCV, Valencia, Spain
| | | | - Álvaro Hidalgo-Vega
- Weber Foundation, Madrid, Spain.,Department of Economic Analysis and Finances, University of Castilla-La Mancha, Toledo, Spain
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11
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Rare Neurological Diseases: an Overreview of Pathophysiology, Epidemiology, Clinical Features and Pharmacoeconomic Considerations in the Treating. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2021. [DOI: 10.2478/sjecr-2021-0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Rare diseases (RD) are serious chronic diseases affecting small number of people compared to the general population. There are between 6000 and 8000 RDs, which affect about 400 million people worldwide. Drugs used for causal treatment of RDs are called orphan drugs. RDs bear great clinical and economic burden for patients, their families, healthcare systems and society overall. There are at least two reasons for the high cost of treatment of RDs. First, there is no causal therapy for majority of RDs, so exacerbations, complications, and hospitalizations in those patients are common. The second reason is high price of available orphan drugs, which are not cost-effective when traditional pharmacoeconomic evaluation is employed. The pharmacoeconomic aspect of the treatment of RDs is especially important in the field of neurology, since at least one fifth of all RDs is composed of neurological conditions. The aim of this paper was to provide a concise overview of the pathophysiological, epidemiological and clinical characteristics of some of the most important and common rare neurological diseases, with special reference to their impact on society and economy.
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