Direct costs of adhering to selected Duchenne muscular dystrophy Care Considerations: Estimates from a midwestern state

Kristin M Conway; Scott D Grosse; Lijing Ouyang; Natalie Street; Paul A Romitti

doi:10.1002/mus.27505

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Direct costs of adhering to selected Duchenne muscular dystrophy Care Considerations: Estimates from a midwestern state

Journal article

Peer reviewed

Direct costs of adhering to selected Duchenne muscular dystrophy Care Considerations: Estimates from a midwestern state

Kristin M Conway, Scott D Grosse, Lijing Ouyang, Natalie Street and Paul A Romitti

Muscle & nerve, Vol.65(5), pp.574-580

01/22/2022

DOI: 10.1002/mus.27505

PMCID: PMC9109677

PMID: 35064961

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https://www.ncbi.nlm.nih.gov/pmc/articles/9109677View

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Abstract

The multidisciplinary Duchenne muscular dystrophy (DMD) Care Considerations were developed to standardize care and improve outcomes. We provide cumulative cost estimates for selected key preventive (ie, excluding new molecular therapies and acute care) elements of the care considerations in eight domains (neuromuscular, rehabilitation, respiratory, cardiac, orthopedic, gastrointestinal, endocrine, psychosocial management) independent of completeness of uptake or provision of nonpreventive care. We used de-identified insurance claims data from a large midwestern commercial health insurer during 2018. We used Current Procedural Terminology and national drug codes to extract unit costs for clinical encounters representing key preventive elements of the DMD Care Considerations. We projected per-patient cumulative costs from ages 5 to 25 years for these elements by multiplying a schedule of recommended frequencies of preventive services by unit costs in 2018 US dollars. Assuming a diagnosis at age 5 years, independent ambulation until age 11, and survival until age 25, we estimated 670 billable clinical events. The 20-year per-patient cumulative cost was $174 701 with prednisone ($2.3 million with deflazacort) and an expected total of $12 643 ($29 194) for out-of-pocket expenses associated with those events and medications. Standardized monitoring of disease progression and treatments may reduce overall costs of illness. Costs associated with these services would be needed to quantify potential savings. Our approach demonstrates a method to estimate costs associated with implementation of preventive care schedules.

Muscular Dystrophy

guidelines

DMD care considerations

clinical

cost of care

Duchenne muscular dystrophy

Details

Title: Subtitle: Direct costs of adhering to selected Duchenne muscular dystrophy Care Considerations: Estimates from a midwestern state
Creators: Kristin M Conway - Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA
Scott D Grosse - National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Lijing Ouyang - National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Natalie Street - National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Paul A Romitti - Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA
Resource Type: Journal article
Publication Details: Muscle & nerve, Vol.65(5), pp.574-580
DOI: 10.1002/mus.27505
PMID: 35064961
PMCID: PMC9109677
NLM abbreviation: Muscle Nerve
eISSN: 1097-4598
Language: English
Date published: 01/22/2022
Academic Unit: Epidemiology; Biostatistics
Record Identifier: 9984216739102771

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