Abstract
BackgroundMyasthenia gravis is a rare autoimmune neuromuscular disorder. The disorder requires long-term use of expensive medication to control clinical symptoms. This study analyzed the change in trends of total medical expenses and out-of-pocket expenses for patients with myasthenia gravis and explored the factors influencing them.MethodsIn this retrospective study, data were derived from a survey of medical service utilization for patients insured by the Urban Basic Medical Insurance in China from 2013 to 2015. The cost data of 3347 patients with myasthenia gravis were included in this study. The baseline characteristics and medical expenses for patients with myasthenia gravis were analyzed using a descriptive method. The difference and influencing factors of the out-of-pocket ratio were analyzed from both outpatient and inpatient expenses by using the quantile regression method.ResultsThe total expenses reimbursed by the Urban Basic Medicine Insurance for all patients with myasthenia gravis fell progressively from 73.1 to 58.7% during the study period. Patients’ out-of-pocket expenses increased gradually, of which expenses within the scope of Basic Medicine Insurance increased from 14.7 to 22.6% and expenses outside of the Basic Medicine Insurance scope increased from 12.6 to 18.7%. Moreover, the panel quantile results showed a positive correlation between the year of receiving treatment and the out-of-pocket ratio. In addition to the 25th quantile of the out-of-pocket ratio among outpatients with myasthenia gravis, there were significant differences in medical insurance and medical institution among all the other quantiles. Significant regional differences were found in all quantiles of the out-of-pocket ratio, except for the 75th quantile among inpatients. Lastly, age had a negative effect on inpatients with myasthenia gravis across all quantiles, but not on outpatients.ConclusionsFrom 2013 to 2015, patients with myasthenia gravis’s out-of-pocket expenses increased progressively. Moreover, the individual out-of-pocket ratio was affected by the year, medical insurance, medical institution, region, and age. The current medical insurance policy for the general public has a low ability to cater for patients with myasthenia gravis.
Highlights
Myasthenia gravis is a rare autoimmune neuromuscular disorder
Study design The data for this study were obtained from the Survey of Medical Service Utilization for Patients Insured by Urban Basic Medicine Insurance (UBMI) in China
The survey population was a sample of urban patients from all provinces in China covered by UBMI
Summary
Myasthenia gravis is a rare autoimmune neuromuscular disorder. The disorder requires long-term use of expensive medication to control clinical symptoms. Almost all patients with MG need long-term treatment with expensive medication to control their clinical symptoms [3, 4] and even the cost of symptomatic treatment is gradually increasing [5, 6]. This rapid increase in health expenditure can deprive many patients of essential treatment because they cannot afford it [7]. In 2008, the European Commission appealed to all countries to improve the recognition and visibility of rare diseases [8]. To date, China has not developed a systematic approach to reduce the medical and financial burden of patients with rare diseases, except for universal health coverage
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