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KMID : 1022820200110020053
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Journal of Multiple Sclerosis and Neuroimmunology
2020 Volume.11 No. 2 p.53 ~ p.58
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Cost Effectiveness of First-Line Rituximab in Koreans with Neuromyelitis Optica Spectrum Disorder
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Hyun Jae-Won
Jang Hyun-Min
Park Jeong-Mi
Lee Min-Young
Kim Su-Hyun
Kim Ho-Jin
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Abstract
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Background: This study aimed to evaluate the cost-effectiveness of first-line rituximab therapy in individuals with neuromyelitis optica spectrum disorder (NMOSD) in Korea.
Methods: This study enrolled 42 participants with NMOSD from the clinic of neuroimmunological diseases of the central nervous system at National Cancer Center. Of these participants, 21 were treated with first-line rituximab therapy (first-line rituximab group) and 21 were treated with second-line rituximab after switching from azathioprine therapy (second-line rituximab group). Data on direct medical resource consumption, including hospitalizations for acute attack management, clinic visits to physicians, examinations, medication use, and rehabilitation, were collected through a review of medical records and structured interviews of participants. The mean annual direct medical cost per person for the 5 years after maintenance immunosuppressive therapy was investigated and compared between the two groups.
Results: The mean total annual direct medical cost per person was 8.9 million won. The mean annual direct medical cost per person was 1.8 times higher in the second-line rituximab group than in the first-line rituximab group (10.0 vs. 5.5 million won; p=0.028). The mean annual direct medical cost per person during azathioprine therapy (14.8 million won) in the second-line rituximab group was significantly higher than that in the first-line rituximab group (p=0.015).
Conclusions: Even without considering indirect costs, NMOSD has a high economic burden in Korea. These results suggest that first-line rituximab therapy is more cost-effective than first-line azathioprine therapy in individuals with NMOSD.
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KEYWORD
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Neuromyelitis optica spectrum disorder, Cost, Azathioprine, Rituximab
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