Journal of Multiple Sclerosis and Neuroimmunology 11(2):53-58, 2020
Cost Effectiveness of First-Line Rituximab in Koreans with Neuromyelitis Optica Spectrum Disorder
Jae-Won Hyun, MD, PhD, Hyunmin Jang, RN, Jeongmi Park, MDa , Min Young Lee, MD, Su-Hyun Kim, MD, PhD, Ho Jin Kim, MD, PhD
Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, Korea Department of rehabilitation, Gyeonggi Wellness Geriatric Hospital, Yangju, Korea
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.
Journal of Multiple Sclerosis and Neuroimmunology 11(2):53-58, 2020
