Healthcare costs and burden of myasthenia gravis for patients and society: a systematic review.

BACKGROUND AND

objectivesNew and costly therapies for myasthenia gravis (MG) have been approved during the last years, and many more are in the pipeline. Cost-benefit analyses are needed as part of defining start and stop criteria for such treatments. In this systematic review, we examine healthcare costs associated with MG:

methodsA systematic literature search combined the word "myasthenia gravis" with "health resources", and "costs". 1374 records were identified initially, and 44 were included in the final review.

resultsDirect costs include treatment and follow-up in the primary and specialist health care. They were estimated to €3 500-12 000 per MG patient per year in the Nordic countries, similar in other European countries, and higher in United States. Indirect costs include productivity loss, welfare payments, time loss due to medical follow-up, and productivity loss for caregivers. They were estimated to €2 500-8 700 per patient per year in the Nordic countries, the highest figures appearing when all indirect costs were accounted for. A marked reduction in working capacity and an increase in welfare payments due to MG have been reported. Intangible costs include value of lost life-years and reduced quality of life, which are rarely assessed, but have been estimated to be half of the total societal MG costs. DISCUSSION: Total costs of MG need to be included together with the expected benefits from new treatments when performing cost-benefit analyses. Precise knowledge of such costs is essential for healthcare planning and to ensure the availability of optimal treatments.