A recently published Argentina-based cross-sectional study suggested that neuromyelitis optica spectrum disorder (NMOSD) is associated with increased healthcare utilization. However, access to the top care needed remains a problem as insurance remains a barrier.1
Senior Investigator Edgar C. Contentti, MD, MSc, Assistant Professor, Department of Neurosciences, Hospital Aleman, Argentina, and colleagues compared practical outcomes in terms of access to care and NMOSD burden in a cohort of 100 patients in Argentina. It was intended to assess the patient experience. conditions. A self-administered study that collected data on age, sex, education level, employment, duration of NMOSD, clinical characteristics, complementary diagnostic tests, access to NMOSD diagnosis, access to specialized NMSOD treatment centers, and recurrence of NMOSD. Anonymous web-based survey Over the past 6 months, a survey of neurological disorders and long-term NMOSD treatment use was sent to 156 NMSOD patients, of whom 100 (64.1%) completed studies were identified. I was.
Patients who completed the survey were divided into three groups: private health insurance (PHI), social health insurance (SHI), and public health insurance (SRHI, Department of Public Health). Overall, the patient had a mean age at diagnosis of 38.7 years, a mean Diastolic Disability Status Scale (EDSS) score of 2.8 (±2.3), and he had a follow-up of 5.2 (±4.02) years. Sociodemographically, 51% of patients were employed (full-time, 57.5%), 11% were currently unemployed, and 13% were retired due to medical conditions.
In terms of healthcare access, just over half (55%) of the participants had 2-3 professional visits (general neurologists or neuroimmunology specialists) before their final diagnosis of NMOSD. visited for a second opinion. Anti-aquaporin-4 and/or MOG antibody testing, which is an essential component in confirming certain autoimmune diseases like NMOSD, was requested by her 91% of patients. However, health insurance partially covered this test in 15% of his cases. Notably, her 33% of these patients paid the full amount of their pocket.
“Our study provides a real-world understanding of the range of barriers that low-prevalence diseases may face to access appropriate care. shows how the availability of therapeutics for this disease will affect patients in our region and elsewhere.” wrote Contentti et al.1 “Universal access to diagnostic tests, MRI studies, and NMOSD-specific treatments is needed to improve the management of NMOSD patients worldwide.”
Care also varied among medical institutions, with patients reporting more access to MRI and outpatient neurology visits occurring at private centers compared to public institutions. Moreover, these patients had fewer barriers to obtaining NMOSD-specific medications. In the context of this study, rituximab, azathioprine, and mycophenolate mofetil were the most commonly used agents. has been reported to2
read more: Older patients with NMOSD experience transverse myelitis more frequently
Although more than half of the cohort had seen more than one neurologist before diagnosis, approximately 3 in 10 (29%) of people with NMOSD visited at least one specialized NMOSD center in their city. I know and report. Additionally, 24% of patients undergoing neurological rehabilitation at the time of the survey, and 29% of them, were out-of-pocket, significantly more frequently in the public sector than in PHI and SHI departments.
The study documented access to immunosuppressive therapy (IST), an important component of NMOSD care, as most patients (92%) had IST and 74% had it as prescribed by a neurologist. rice field. Compared with PHI and SHI, the SRHI group had mean time to MRI, neurologic outpatient visits, use of MRI for pain, and unemployment. Notably, regression analysis showed that private insurance was the only factor associated with adequate access to long-term NMOSD-specific medications, including IST, prescribed by a neurologist.
The researchers said, “Our findings have the potential to be a useful tool for national health care and decision makers. It suggests that there is
