Evidence map›Paper›PMID 31842786›Full record

ArticleBMC neurology2019

Recent transition of medical cost and relapse rate of multiple sclerosis in Japan based on analysis of a health insurance claims database.

Izumi Kawachi, Shuichi Okamoto, Mariko Sakamoto, Hiroyuki Ohta, Yusuke Nakamura, Kosuke Iwasaki, Manami Yoshida, Shinzo Hiroi, Mieko Ogino

Abstract read
In one paragraph

Article in BMC neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Izumi KawachiDepartment of Neurology, Brain Research Institute, Niigata University, 1-757 Asahimachi, Chuo-ku, Niigata, 951-8585, Japan. ikawachi@bri.niigata-u.ac.jp.ORCID http://orcid.org/0000-0002-7140-8500
Shuichi OkamotoJapan Medical Affairs, Takeda Pharmaceutical Company Limited, 2 Chome-1-1 Nihonbashi-Honcho, Chuo-ku, Tokyo, 103-8668, Japan.
Mariko SakamotoJapan Medical Affairs, Takeda Pharmaceutical Company Limited, 2 Chome-1-1 Nihonbashi-Honcho, Chuo-ku, Tokyo, 103-8668, Japan.
Hiroyuki OhtaJapan Medical Affairs, Takeda Pharmaceutical Company Limited, 2 Chome-1-1 Nihonbashi-Honcho, Chuo-ku, Tokyo, 103-8668, Japan.
Yusuke NakamuraMilliman, 1-6-2-8F Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan.
Kosuke IwasakiMilliman, 1-6-2-8F Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan.
Manami YoshidaJapan Medical Affairs, Takeda Pharmaceutical Company Limited, 2 Chome-1-1 Nihonbashi-Honcho, Chuo-ku, Tokyo, 103-8668, Japan.
Shinzo HiroiJapan Medical Affairs, Takeda Pharmaceutical Company Limited, 2 Chome-1-1 Nihonbashi-Honcho, Chuo-ku, Tokyo, 103-8668, Japan.
Mieko OginoInternational University of Health and Welfare, School of Medicine, Center for Medical Education, 4-2 Kozunomori, Narita, Chiba, 286-8686, Japan.

Funding

Takeda Pharmaceutical Company Limited none
6 · The paper itself

Abstract

backgroundIn this study, we aimed to understand the trends in total and itemized medical expenses, especially of disease-modifying therapy (DMT), for multiple sclerosis (MS) in Japan through an analysis of health insurance claims data.

methodsWe analyzed a database containing health insurance claims data from hospitals that have adopted the Diagnosis Procedure Combination/Per-Diem Payment System in Japan. According to an algorithm based on diagnosis codes, data for all patients diagnosed with MS from April 2008 to July 2016 were extracted. Medical costs, rate of each medical treatment, and rate of relapses were analyzed by calendar-year. Medical costs in the month of relapse were compared with average medical costs per month of all MS patients by a cross-sectional analysis.

resultsFour thousand three hundred seventy-four MS patients were identified in the database. Total medical cost per patient per month (PPPM) increased from ¥87,640 (US$787.7 or €723.0 as of May 2017) to ¥102,846 (US$924.4 or €848.4) during the study period. This increment was mainly attributed to the growth in cost of outpatient DMT prescriptions, which increased from ¥23,039 (US$207.1 or €190.1) to ¥51,351 (US$461.5 or €423.6). In contrast, the rate of hospitalizations and relapses PPPM decreased during the study period (from 0.053 to 0.030, and 0.032 to 0.019, respectively). Medical costs in the month of relapse (¥424,661, US$3816.8 or €3503.1) were 3.57 times higher than the average monthly costs for all MS patients (¥119,021, US$1069.8 or €981.8), with the majority comprising hospitalization cost.

conclusionConcomitant with the increased usage of DMT, the total medical cost for treating MS is increasing in Japan. However, rates of relapse and hospitalization have shown a decreasing trend. Although this study does not show the direct causality between DMT and reduction of relapse rates/fewer hospitalizations among MS patients, a reduction in hospital costs has been revealed concomitantly with the increasing prevalence of DMT.

Indexed as

AdultChronic DiseaseCosts and Cost AnalysisCross-Sectional StudiesDatabases, FactualFemaleHumansImmunosuppressive AgentsJapanMaleMiddle AgedMultiple SclerosisRecurrenceImmunosuppressive AgentsClaims databaseDisease-modifying therapyHealth economicsMultiple sclerosisReal-world dataRelapse rate

Identifiers

PMID31842786
PMCPMC6912943

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LicenceCC BY
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.