Cost analysis of methylprednisolone treatment of multiple sclerosis patients.
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.


CONCLUSIONS
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.
Institute for Work and Health, Toronto, Canada.
L S
LS
Robson
C
C
Bain
S
S
Beck
S
S
Guthrie
P C
PC
Coyte
P
P
O'Connor
D000553:Ambulatory Care / Q000191:economics; D000893:Anti-Inflammatory Agents / Q000191:economics* / Q000627:therapeutic use*; D002170:Canada; D003365:Costs and Cost Analysis; D005251:Fees, Medical; D006699:Home Care Services / Q000191:economics; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008775:Methylprednisolone / Q000191:economics* / Q000627:therapeutic use*; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000191:economics*
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone