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April 23, 2019; 92 (17) Article

Cost of illness in Charcot-Marie-Tooth neuropathy

Results from Germany

Elisabeth Schorling, Simone Thiele, Laura Gumbert, Sabine Krause, Constanze Klug, Olivia Schreiber-Katz, Peter Reilich, Klaus Nagels, Maggie C. Walter
First published March 27, 2019, DOI: https://doi.org/10.1212/WNL.0000000000007376
Elisabeth Schorling
From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany.
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Simone Thiele
From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany.
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Laura Gumbert
From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany.
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Sabine Krause
From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany.
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Constanze Klug
From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany.
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Olivia Schreiber-Katz
From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany.
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Peter Reilich
From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany.
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Klaus Nagels
From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany.
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Maggie C. Walter
From the Institute for Healthcare Management and Health Sciences (E.S., C.K.) and Healthcare Management and Health Services Research (L.G., K.N.), University of Bayreuth; Department of Neurology (S.T., S.K., P.R., M.C.W.), Friedrich-Baur-Institute, Ludwig-Maximilians-University of Munich; and Department of Neurology (O.S.-K.), Hannover Medical School, Germany.
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Cost of illness in Charcot-Marie-Tooth neuropathy
Results from Germany
Elisabeth Schorling, Simone Thiele, Laura Gumbert, Sabine Krause, Constanze Klug, Olivia Schreiber-Katz, Peter Reilich, Klaus Nagels, Maggie C. Walter
Neurology Apr 2019, 92 (17) e2027-e2037; DOI: 10.1212/WNL.0000000000007376

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This article has a correction. Please see:

  • Cost of illness in Charcot-Marie-Tooth neuropathy - August 27, 2019
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Abstract

Objective To assess cost associated with the disease-specific need of patients diagnosed with Charcot-Marie-Tooth neuropathies (CMT) in Germany.

Methods Patients with CMT were identified through the national patient registry and invited to complete a standardized questionnaire. The data collected include information about health care use, informal care, and other disease-related expenses as well as the working situation. Based on this information, we estimated the annual cost of CMT from the perspective of society.

Results This study included 397 patients with a genetically confirmed CMT diagnosis. We estimated total annual cost of illness (COI) of $22,362 (95% CI $19,464–$25,723) per patient, of which 67.3% were direct costs. The highest single cost factor was informal care cost. For Germany, we extrapolated total cost of CMT of $735.0 million ($639.8 million–$845.5 million). Multivariate regression analysis showed that total annual cost increased with disease severity (Charcot-Marie-Tooth Neuropathy Score). Age, CMT subtype, comorbidities, body mass index, and employment status were also predictors of a change in cost (p < 0.05). Moreover, we found differences in total cost depending on marital status, subjectively evaluated impairments, dependence on other persons, care level, educational level, and disease duration.

Conclusions CMT is associated with a substantial economic burden. For the first time, the COI of CMT has been assessed and will serve as important input to decision-making in health policy, especially regarding research and development of therapies. Moreover, our results indicate the importance of the patient-reported perception of disease severity related to the consumption of resources.

Glossary

CI=
confidence interval;
CMT=
Charcot-Marie-Tooth;
CMTNS=
CMT Neuropathy Score;
COI=
cost of illness;
DMD=
Duchenne muscular dystrophy;
GLM=
generalized linear model;
HNPP=
hereditary neuropathy due to pressure palsies;
SMA=
spinal muscular atrophy

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • ↵* These authors contributed equally to this work.

  • Received October 16, 2018.
  • Accepted in final form January 3, 2019.
  • © 2019 American Academy of Neurology
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