Real-World Resource Utilization and Productivity Loss Among Patients With Myasthenia Gravis in Sweden: A Nationwide Population-Based Study

Abstract

Objective To assess annual healthcare resource utilization including inpatient admission and outpatient visits, employment status, and sickness absence associated with myasthenia gravis (MG). Background MG is a rare, chronic and debilitating autoimmune neuromuscular disease characterized by muscle weakness and fatigue that leads to hallmark symptoms including ptosis, dysphagia, dyspnea and limb weakness. Nearly 10% of patients are estimated to have treatment-refractory MG. Design/Methods Data were linked from four longitudinal nationwide population-based registries in Sweden. Patients with = 1 diagnosis of MG (ICD-10 G70.0) from 01/01/2001 to 12/30/2017 were selected. Date of 1st MG diagnosis in the national patient register was designated as index date. The healthcare resource use, employment status, and sickness absence for all cause and associated with MG within 1-year post-index period were evaluated. Results A total of 4,339 patients with newly diagnosed MG were identified from 2001 and 2017. Mean (±SD) age at index date was 59.8 (±19.5) years; 54% were female. During the first year post-MG diagnosis, 50.6% of patients) had = 1 MG-related inpatient admission and 23.6% spent >1 month as an inpatient. Most patients (89.3%, n = 3,875) had = 1 specialist visits for MG and 16.1% had >5 visits during 1-year post-index period. 58.9% of patients had = 1 all-cause inpatient admission and 97.5% of patients used = 1 outpatient specialist services in the same period. Among patients of working age with =1-year follow-up (n = 2,006), 37.3% of them were not employed; among those in employment (n = 1,250), 44.6% reported = 1 sickness absences within 1-year post-index period. Conclusions Patients with MG require considerable care both for MG and comorbidities over a period of years. An important sub-population of patients (e.g., those with MG crisis) may be the intensive users of both inpatient and outpatient care. Future research needs to detail treatment pattern and outcomes in this population.