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Cost Analysis of Methylprednisolone Treatment of Multiple Sclerosis Patients

Published online by Cambridge University Press:  18 September 2015

Lynda S. Robson
Affiliation:
Institute for Work and Health, Toronto
Charlene Bain
Affiliation:
Department of Health Administration
Shann Beck
Affiliation:
Sunnybrook Health Sciences Centre, Toronto
Suzanne Guthrie
Affiliation:
Simcoe County District Health Unit, Orillia
Peter C. Coyte
Affiliation:
Department of Health Administration Institute for Clinical Evaluative Sciences in Ontario, Toronto Hospital Management Research Unit, Institute for Policy Analysis, Centre for the Study of State and Market, University of Toronto Wellesley Hospital Research Unit, Toronto
Paul O'Connor*
Affiliation:
St. Michael's Hospital, Toronto
*
Division of Neurology, St. Michael's Hospital, 30Bond Street, Toronto, Ontario, Canada M5B 1W8
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Abstract:

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Background:

Intravenous methylprednisolone (IVMP) is the treatment of choice for multiple sclerosis (MS) patients undergoing acute exacerbation of disease symptoms and yet its cost has not been accurately determined. Determination of this cost in different settings is also pertinent to consideration of cost-saving alternatives to in-patient treatment.

Methods:

Cost analysis from the point of view of the health care system of IVMP treatment of MS patients receiving treatment in association with a selected Toronto teaching hospital in fiscal year 1994/95 was carried out. Costs of any concurrent treatments were excluded.

Results:

Total cost for 92 patients, based on a 4 dose regime, was estimated to be $78,527. The the cost per patient was $1,1181.84 for in-patients (IP), $714.64 for out-patients of the MS Clinic (OP) and $774.21 for patients whose treatment was initiated in the Clinic, but completed in the home (HC). Sensitivity analyses indicated: 1) IP treatment was in all cases more expensive than that of OP or HC; 2) the cost savings of OP vs. HC was sensitive to assumptions made regarding Clinic overhead, Clinic nursing costs and Home Care Program overhead.

Conclusion:

Alternatives to in-patient care must be considered carefully. In this study, both out-patient and in-home treatment were cost-saving alternatives to in-patient treatment, but large differences in the cost of hospital out-patient vs. in-home care could not be demonstrated.

Type
Original Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1998

References

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