Dataset Information

Healthcare expenditure of multiple sclerosis patients in 2013: A nationwide study based on French health administrative databases.

ABSTRACT:

Background

Little is known about expenditure items of multiple sclerosis (MS) patients over recent years in France.

Objective

To describe healthcare expenditure among MS patients and identify the main expenditure drivers.

Methods

All healthcare expenditure reimbursed by French National Health Insurance to MS patients in 2013 was described on the basis of nationwide health administrative databases (SNIIRAM/PMSI). Expenditure was described globally and according to age and sex.

Results

The average expenditure among the 90,288 MS patients included was €11,900 per patient. Pharmacy and hospitalisation accounted for 47% and 23% of healthcare expenditure, respectively (38% and 22% of MS patients were treated with disease-modifying therapies and hospitalised overnight or longer, respectively). Average expenditure did not differ according to age. However, pharmacy expenditure decreased with age (from 71% between the ages of 20 and 29 years to 18% between the ages of 70 and 79 years), whereas hospitalisation expenditure increased with age (from 15% to 35%). Paramedical fees accounted for 2% of expenditure between the ages of 20 and 29 years and 24% between the ages of 70 and 79 years.

Conclusion

Overall, pharmacy expenditure was the main expenditure item, which decreased with increasing age, while hospitalisation and paramedical expenditure increased with increasing age.

SUBMITTER: Lefeuvre D

PROVIDER: S-EPMC5600306 | biostudies-literature | 2017 Jul-Sep

REPOSITORIES: biostudies-literature

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Publications

Healthcare expenditure of multiple sclerosis patients in 2013: A nationwide study based on French health administrative databases.

Lefeuvre Delphine D Rudant Jérémie J Foulon Stéphanie S Alla François F Weill Alain A

Multiple sclerosis journal - experimental, translational and clinical 20170701 3

<h4>Background</h4>Little is known about expenditure items of multiple sclerosis (MS) patients over recent years in France.<h4>Objective</h4>To describe healthcare expenditure among MS patients and identify the main expenditure drivers.<h4>Methods</h4>All healthcare expenditure reimbursed by French National Health Insurance to MS patients in 2013 was described on the basis of nationwide health administrative databases (SNIIRAM/PMSI). Expenditure was described globally and according to age and se ...[more]

PMID: 28932411

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Project description:BackgroundDirect antiviral agents (DAAs) became available in France in 2014 for the treatment of chronic hepatitis C (CHC) in patients with severe fibrosis (prioritized access); in 2017, DAAs became available to all CHC patients (universal access). We evaluated the impact of extending DAA availability on CHC patient care, especially on screening and time to treatment.MethodsAdult patients affiliated with the national health insurance system (SNDS) who were screened or treated for CHC between 2015 and 2019 were included. Algorithms were developed to identify at-risk subpopulations.FindingsThe proportion of screened patients increased by 1% between 2015 and 2019, from 4·6% to 5·6%. The main nonexclusive risk factors for CHC were psychiatric conditions (27%), drug use (21%) and HIV positivity (11%); more than 50% of psychiatric patients had additional risk factors, mainly drug use with a 38% to 52% overlap.The median interval between the last screening test and treatment initiation decreased from 64 days in 2015 to 37 days in 2019.During the study period, 71,466 patients began CHC treatment (median age 55 [48-62]; 59% male), including 46% of "at-risk" patients with an increase in treatment initiation by 44% between 2015 and 2017 and a decrease of 46% between 2017 and 2019. Only 2,212 (3%) patients were treated at least twice.Among treated patients, the proportion of HIV+ patients decreased from 19% to 8% (prioritization consequence), while the proportions increased in the other at-risk subpopulations.Interpretationwe showed that policies extending DAA availability are associated with a screening increase and a decrease in the time to treatment initiation, while universal access led to a surge in treatment initiations in 2017. This study may also contribute to improving the cascade of care in the at-risk subpopulations. For instance, by pointing out their relative importance, especially for the psychiatric subpopulation, it highlights the importance to address them with tailored policies.

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Dataset Information

Healthcare expenditure of multiple sclerosis patients in 2013: A nationwide study based on French health administrative databases.

Background

Objective

Methods

Results

Conclusion

Publications

Healthcare expenditure of multiple sclerosis patients in 2013: A nationwide study based on French health administrative databases.

Similar Datasets

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