The socioeconomic burden of facioscapulohumeral muscular dystrophy

J Neurol. 2021 Dec;268(12):4778-4788. doi: 10.1007/s00415-021-10591-w. Epub 2021 May 27.

Abstract

Background: Promising genetic therapies are being investigated in facioscapulohumeral muscular dystrophy (FSHD). However, the current cost of illness is largely unknown.

Objective: This study aimed at determining the socioeconomic burden of FSHD.

Methods: Adult patients with FSHD from the Dutch FSHD registry were invited to complete a questionnaire on medical consumption, work productivity and health-related quality of life (HR-QoL) using the EQ-5D-5L. Associated costs were calculated from a societal perspective. A generalized linear model was fitted to the data to investigate whether level of mobility was related to annual costs of illness.

Results: 172 patients with FSHD completed the questionnaire (response rate 65%). The per-patient annual direct medical costs of FSHD were estimated at €12,077, direct non-medical costs at €9179 and indirect costs at €5066, adding up to a total cost of illness of €26,322 per patient per year. The direct costs of illness were €21,256, approximately five times higher than the mean per-capita health expenditures in the Netherlands. Major cost-driving factors were formal home care and informal care. A decreased level of mobility was associated with higher direct costs of illness. HR-QoL was significantly reduced in patients with FSHD with a median health utility value of 0.63.

Conclusions: We show that FSHD is associated with substantial direct and indirect socioeconomic costs as well as a reduction in HR-QoL. These findings are important for health care decision makers and aids in allocation of research funds and evaluation of the cost-effectiveness of novel therapies.

Keywords: Burden; Cost; Muscle disease; Quality of life.

MeSH terms

  • Adult
  • Cost of Illness
  • Cross-Sectional Studies
  • Humans
  • Muscular Dystrophy, Facioscapulohumeral* / epidemiology
  • Muscular Dystrophy, Facioscapulohumeral* / therapy
  • Quality of Life*
  • Socioeconomic Factors
  • Surveys and Questionnaires