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Published in: The European Journal of Health Economics 1/2016

01-04-2016 | Original Paper

Social/economic costs and health-related quality of life of mucopolysaccharidosis patients and their caregivers in Europe

Authors: Márta Péntek, László Gulácsi, Valentin Brodszky, Petra Baji, Imre Boncz, Gábor Pogány, Julio López-Bastida, Renata Linertová, Juan Oliva-Moreno, Pedro Serrano-Aguilar, Manuel Posada-de-la-Paz, Domenica Taruscio, Georgi Iskrov, Arrigo Schieppati, Johann Matthias Graf von der Schulenburg, Panos Kanavos, Karine Chevreul, Ulf Persson, Giovanni Fattore, BURQOL-RD Research Network

Published in: The European Journal of Health Economics | Special Issue 1/2016

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Abstract

Objectives

To assess the health-related quality of life (HRQOL) of patients with mucopolysaccharidosis (MPS) and their caregivers and to quantify the disease-related costs from a societal perspective.

Methods

In the context of a multi-country study of rare diseases (BURQOL-RD project), a cross-sectional survey was performed among MPS patients in seven European countries. Data on demographic characteristics, health resource utilization, informal care, and loss of labor productivity were collected. The EQ-5D, Barthel index (BI), and Zarit burden interview (ZBI) questionnaires were used to assess patients’ and their informal caregivers’ quality of life, patients’ functional ability, and caregivers’ burden, respectively.

Results

Altogether, 120 patients (children 62 %, females 40 %) and 66 caregivers completed the questionnaire. Patients’ mean age was 16.5 years and median age at diagnosis was 3 years. Adult patients’ average EQ-5D and EQ VAS scores varied across countries from 0.13 to 0.43 and 30.0 to 62.2, respectively, mean BI was 46.7, and ZBI was 32.7. Mean informal care time was 51.3 h/week. The mean total annual cost per patient (reference year 2012) was €24,520 in Hungary, €25,993 in France, €84,921 in Italy, €94,384 in Spain, and €209,420 in Germany. Costs are also shown to differ between children and adults. Direct costs accounted for most of the costs in all five countries (80, 100, 99, 98, and 93 %, respectively).

Conclusions

MPS patients experience substantial loss of HRQOL and their families take a remarkable part in their care. Although utilization of health and social care resources varies significantly across countries, MPS incurs considerable societal costs in all the countries studied.
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Literature
1.
go back to reference Muenzer, J.: The mucopolysaccharidoses: a heterogeneous group of disorders with variable pediatric presentations. J. Pediatr. 144, S27–S34 (2004)CrossRefPubMed Muenzer, J.: The mucopolysaccharidoses: a heterogeneous group of disorders with variable pediatric presentations. J. Pediatr. 144, S27–S34 (2004)CrossRefPubMed
2.
go back to reference Muenzer, J.: Overview of the mucopolysaccharidoses. Rheumatology (Oxford) 50, v4–v12 (2011)CrossRef Muenzer, J.: Overview of the mucopolysaccharidoses. Rheumatology (Oxford) 50, v4–v12 (2011)CrossRef
3.
go back to reference Braunlin, E.A., Harmatz, P.R., Scarpa, M., Furlanetto, B., Kampmann, C., Loehr, J.P., Ponder, K.P., Roberts, W.C., Rosenfeld, H.M., Giugliani, R.: Cardiac disease in patients with mucopolysaccharidosis: presentation, diagnosis and management. J. Inherit. Metab. Dis. 34, 1183–1197 (2011)CrossRefPubMedPubMedCentral Braunlin, E.A., Harmatz, P.R., Scarpa, M., Furlanetto, B., Kampmann, C., Loehr, J.P., Ponder, K.P., Roberts, W.C., Rosenfeld, H.M., Giugliani, R.: Cardiac disease in patients with mucopolysaccharidosis: presentation, diagnosis and management. J. Inherit. Metab. Dis. 34, 1183–1197 (2011)CrossRefPubMedPubMedCentral
4.
go back to reference Ashworth, J., Flaherty, M., Pitz, S., Ramlee, A.: Assessment and diagnosis of suspected glaucoma in patients with mucopolysaccharidosis. Acta Ophthalmol. 93, e111–e117 (2015)CrossRefPubMed Ashworth, J., Flaherty, M., Pitz, S., Ramlee, A.: Assessment and diagnosis of suspected glaucoma in patients with mucopolysaccharidosis. Acta Ophthalmol. 93, e111–e117 (2015)CrossRefPubMed
5.
go back to reference Berger, K.I., Fagondes, S.C., Giugliani, R., Hardy, K.A., Lee, K.S., McArdle, C., Scarpa, M., Tobin, M.J., Ward, S.A., Rapoport, D.M.: Respiratory and sleep disorders in mucopolysaccharidosis. J. Inherit. Metab. Dis. 36, 201–210 (2013)CrossRefPubMed Berger, K.I., Fagondes, S.C., Giugliani, R., Hardy, K.A., Lee, K.S., McArdle, C., Scarpa, M., Tobin, M.J., Ward, S.A., Rapoport, D.M.: Respiratory and sleep disorders in mucopolysaccharidosis. J. Inherit. Metab. Dis. 36, 201–210 (2013)CrossRefPubMed
7.
go back to reference Leadley, R.M., Lang, S., Misso, K., Bekkering, T., Ross, J., Akiyama, T., Fietz, M., Giugliani, R., Hendriksz, C.J., Hock, N.L., McGill, J., Olaye, A., Jain, M., Kleijnen, J.: A systematic review of the prevalence of Morquio A syndrome: challenges for study reporting in rare diseases. Orphanet. J. Rare Dis. 9, 173 (2014)CrossRefPubMedPubMedCentral Leadley, R.M., Lang, S., Misso, K., Bekkering, T., Ross, J., Akiyama, T., Fietz, M., Giugliani, R., Hendriksz, C.J., Hock, N.L., McGill, J., Olaye, A., Jain, M., Kleijnen, J.: A systematic review of the prevalence of Morquio A syndrome: challenges for study reporting in rare diseases. Orphanet. J. Rare Dis. 9, 173 (2014)CrossRefPubMedPubMedCentral
8.
go back to reference Jurecka, A., Lugowska, A., Golda, A., Czartoryska, B., Tylki-Szymanska, A.: Prevalence rates of mucopolysaccharidoses in Poland. J. Appl. Genet. 56, 205–210 (2015)CrossRefPubMed Jurecka, A., Lugowska, A., Golda, A., Czartoryska, B., Tylki-Szymanska, A.: Prevalence rates of mucopolysaccharidoses in Poland. J. Appl. Genet. 56, 205–210 (2015)CrossRefPubMed
10.
go back to reference Noh, H., Lee, J.I.: Current and potential therapeutic strategies for mucopolysaccharidoses. J. Clin. Pharm. Ther. 39, 215–224 (2014)CrossRefPubMed Noh, H., Lee, J.I.: Current and potential therapeutic strategies for mucopolysaccharidoses. J. Clin. Pharm. Ther. 39, 215–224 (2014)CrossRefPubMed
11.
go back to reference Schlander, M., Beck, M.: Expensive drugs for rare disorders: to treat or not to treat? The case of enzyme replacement therapy for mucopolysaccharidosis VI. Curr. Med. Res. Opin. 25, 1285–1293 (2009)CrossRefPubMed Schlander, M., Beck, M.: Expensive drugs for rare disorders: to treat or not to treat? The case of enzyme replacement therapy for mucopolysaccharidosis VI. Curr. Med. Res. Opin. 25, 1285–1293 (2009)CrossRefPubMed
12.
go back to reference Szegedi, M., Molnar, M.J., Boncz, I., Kosztolanyi, G.: Shift of focus in the financing of Hungarian drugs. Reimbursement for orphan drugs for treating rare diseases: financing of enzyme replacement therapy in Hungary. Orv. Hetil. 155, 1735–1741 (2014)CrossRefPubMed Szegedi, M., Molnar, M.J., Boncz, I., Kosztolanyi, G.: Shift of focus in the financing of Hungarian drugs. Reimbursement for orphan drugs for treating rare diseases: financing of enzyme replacement therapy in Hungary. Orv. Hetil. 155, 1735–1741 (2014)CrossRefPubMed
13.
go back to reference Drummond, M., Towse, A.: Orphan drugs policies: a suitable case for treatment. Eur. J. Health Econ. 15, 335–340 (2014)CrossRefPubMed Drummond, M., Towse, A.: Orphan drugs policies: a suitable case for treatment. Eur. J. Health Econ. 15, 335–340 (2014)CrossRefPubMed
14.
go back to reference Angelis, A., Tordrup, D., Kanavos, P.: Socio-economic burden of rare diseases: a systematic review of cost of illness evidence. Health Policy 119, 964–979 (2015)CrossRefPubMed Angelis, A., Tordrup, D., Kanavos, P.: Socio-economic burden of rare diseases: a systematic review of cost of illness evidence. Health Policy 119, 964–979 (2015)CrossRefPubMed
15.
go back to reference Linertova, R., Serrano-Aguilar, P., Posada-de-la-Paz, M., Hens-Perez, M., Kanavos, P., Taruscio, D., Schieppati, A., Stefanov, R., Pentek, M., Delgado, C., von der Schulenburg, J.M., Persson, U., Chevreul, K., Fattore, G., Worbes-Cerezo, M., Sefton, M., Lopez-Bastida, J.: Delphi approach to select rare diseases for a European representative survey. BURQOL-RD Study Health Policy 108, 19–26 (2012)CrossRefPubMed Linertova, R., Serrano-Aguilar, P., Posada-de-la-Paz, M., Hens-Perez, M., Kanavos, P., Taruscio, D., Schieppati, A., Stefanov, R., Pentek, M., Delgado, C., von der Schulenburg, J.M., Persson, U., Chevreul, K., Fattore, G., Worbes-Cerezo, M., Sefton, M., Lopez-Bastida, J.: Delphi approach to select rare diseases for a European representative survey. BURQOL-RD Study Health Policy 108, 19–26 (2012)CrossRefPubMed
16.
go back to reference Pentek, M., Kosztolanyi, G., Melegh, B., Halasz, A., Pogany, G., Baji, P., Brodszky, V., Vartokne, H.N., Boncz, I., Gulacsi, L.: Cystic fibrosis—disease burden and health-related quality of life of patients and their caregivers: results of the European BURQOL-RD survey in Hungary. Orv. Hetil. 155, 1673–1684 (2014)CrossRefPubMed Pentek, M., Kosztolanyi, G., Melegh, B., Halasz, A., Pogany, G., Baji, P., Brodszky, V., Vartokne, H.N., Boncz, I., Gulacsi, L.: Cystic fibrosis—disease burden and health-related quality of life of patients and their caregivers: results of the European BURQOL-RD survey in Hungary. Orv. Hetil. 155, 1673–1684 (2014)CrossRefPubMed
17.
go back to reference Chevreul, K., Brigham, K.B., Michel, M., Rault, G.: Costs and health-related quality of life of patients with cystic fibrosis and their carers in France. J. Cyst. Fibros. 14, 384–391 (2015)CrossRefPubMed Chevreul, K., Brigham, K.B., Michel, M., Rault, G.: Costs and health-related quality of life of patients with cystic fibrosis and their carers in France. J. Cyst. Fibros. 14, 384–391 (2015)CrossRefPubMed
18.
go back to reference Drummond, M., O’Brien, B., Stoddart, G., Torrance, G.: Methods for the economic evaluation of health care programmes, 2nd edn. Oxford University Press, Oxford (1997) Drummond, M., O’Brien, B., Stoddart, G., Torrance, G.: Methods for the economic evaluation of health care programmes, 2nd edn. Oxford University Press, Oxford (1997)
19.
go back to reference McDaid, D.: Estimating the costs of informal care for people with Alzheimer’s disease: methodological and practical challenges. Int. J. Geriatr. Psychiatry 16, 400–405 (2001)CrossRefPubMed McDaid, D.: Estimating the costs of informal care for people with Alzheimer’s disease: methodological and practical challenges. Int. J. Geriatr. Psychiatry 16, 400–405 (2001)CrossRefPubMed
20.
go back to reference van den Berg, B., Brouwer, W.B., Koopmanschap, M.A.: Economic valuation of informal care. An overview of methods and applications. Eur. J. Health Econ. 5, 36–45 (2004)CrossRefPubMed van den Berg, B., Brouwer, W.B., Koopmanschap, M.A.: Economic valuation of informal care. An overview of methods and applications. Eur. J. Health Econ. 5, 36–45 (2004)CrossRefPubMed
21.
go back to reference Hodgson, T.A., Meiners, M.R.: Cost-of-illness methodology: a guide to current practices and procedures. Milbank Mem. Fund Q. Health Soc. 60, 429–462 (1982)CrossRefPubMed Hodgson, T.A., Meiners, M.R.: Cost-of-illness methodology: a guide to current practices and procedures. Milbank Mem. Fund Q. Health Soc. 60, 429–462 (1982)CrossRefPubMed
22.
23.
go back to reference Szende, Á., Oppe, M., Devlin, N. (eds.): EQ-5D value sets: inventory, comparative review and user guide. Springer, Netherlands (2007) Szende, Á., Oppe, M., Devlin, N. (eds.): EQ-5D value sets: inventory, comparative review and user guide. Springer, Netherlands (2007)
24.
go back to reference Mahoney, F.I., Barthel, D.W.: Functional evaluation: the Barthel index. Md. State Med. J. 14, 61–65 (1965)PubMed Mahoney, F.I., Barthel, D.W.: Functional evaluation: the Barthel index. Md. State Med. J. 14, 61–65 (1965)PubMed
25.
go back to reference Shah, S., Vanclay, F., Cooper, B.: Improving the sensitivity of the Barthel index for stroke rehabilitation. J. Clin. Epidemiol. 42, 703–709 (1989)CrossRefPubMed Shah, S., Vanclay, F., Cooper, B.: Improving the sensitivity of the Barthel index for stroke rehabilitation. J. Clin. Epidemiol. 42, 703–709 (1989)CrossRefPubMed
26.
go back to reference Hébert, R., Bravo, G., Préville, M.: Reliability, validity, and reference values of the Zarit burden interview for assessing informal caregivers of community-dwelling older persons with dementia. Can. J. Aging 19, 494–507 (2000)CrossRef Hébert, R., Bravo, G., Préville, M.: Reliability, validity, and reference values of the Zarit burden interview for assessing informal caregivers of community-dwelling older persons with dementia. Can. J. Aging 19, 494–507 (2000)CrossRef
27.
go back to reference Szende, A., Nemeth, R.: Health-related quality of life of the Hungarian population. Orv. Hetil. 144(34), 1667–1674 (2003)PubMed Szende, A., Nemeth, R.: Health-related quality of life of the Hungarian population. Orv. Hetil. 144(34), 1667–1674 (2003)PubMed
28.
go back to reference Connock, M., Juarez-Garcia, A., Frew, E., Mans, A., Dretzke, J., Fry-Smith, A., Moore, D.: A systematic review of the clinical effectiveness and cost-effectiveness of enzyme replacement therapies for Fabry’s disease and mucopolysaccharidosis type 1. Health Technol. Assess. 10(20), iii–iv, ix–113 (2006) Connock, M., Juarez-Garcia, A., Frew, E., Mans, A., Dretzke, J., Fry-Smith, A., Moore, D.: A systematic review of the clinical effectiveness and cost-effectiveness of enzyme replacement therapies for Fabry’s disease and mucopolysaccharidosis type 1. Health Technol. Assess. 10(20), iii–iv, ix–113 (2006)
29.
go back to reference Hendriksz, C.J., Lavery, C., Coker, M., Ucar, S.K., Jain, M., Bell, L., Lampe, C.: Burden of disease in patients with Morquio A syndrome: results from an international patient-reported outcomes survey. Orphanet J. Rare Dis. 9, 32 (2014)CrossRefPubMedPubMedCentral Hendriksz, C.J., Lavery, C., Coker, M., Ucar, S.K., Jain, M., Bell, L., Lampe, C.: Burden of disease in patients with Morquio A syndrome: results from an international patient-reported outcomes survey. Orphanet J. Rare Dis. 9, 32 (2014)CrossRefPubMedPubMedCentral
30.
go back to reference Guffon, N., Heron, B., Chabrol, B., Feillet, F., Montauban, V., Valayannopoulos, V.: Diagnosis, quality of life, and treatment of patients with Hunter syndrome in the French healthcare system: a retrospective observational study. Orphanet J. Rare Dis. 10, 43 (2015)CrossRefPubMedPubMedCentral Guffon, N., Heron, B., Chabrol, B., Feillet, F., Montauban, V., Valayannopoulos, V.: Diagnosis, quality of life, and treatment of patients with Hunter syndrome in the French healthcare system: a retrospective observational study. Orphanet J. Rare Dis. 10, 43 (2015)CrossRefPubMedPubMedCentral
Metadata
Title
Social/economic costs and health-related quality of life of mucopolysaccharidosis patients and their caregivers in Europe
Authors
Márta Péntek
László Gulácsi
Valentin Brodszky
Petra Baji
Imre Boncz
Gábor Pogány
Julio López-Bastida
Renata Linertová
Juan Oliva-Moreno
Pedro Serrano-Aguilar
Manuel Posada-de-la-Paz
Domenica Taruscio
Georgi Iskrov
Arrigo Schieppati
Johann Matthias Graf von der Schulenburg
Panos Kanavos
Karine Chevreul
Ulf Persson
Giovanni Fattore
BURQOL-RD Research Network
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics / Issue Special Issue 1/2016
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-016-0787-0

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