Fewer hospital stays, lower costs seen with year’s use of Spinraza
US database study tracks inpatient care, related costs in children and adults
People with spinal muscular atrophy (SMA) who are treated with Spinraza (nusinersen) are less likely to require hospitalization or emergency medical care, and hospitalization-related costs correspondingly tend to decrease after starting on the therapy, a U.S. database study reports.
The study, “Evaluation of inpatient and emergency department healthcare resource utilization and costs pre- and post-nusinersen for the treatment of spinal muscular atrophy using United States claims,” was published in the Journal of Comparative Effectiveness Research. The work was funded by Biogen, the company that markets Spinraza, and six of its seven authors were Biogen employees at the time of this study.
Spinraza was the first disease-modifying treatment for SMA to become approved in the U.S. and elsewhere. The therapy, which is given by injection into the spinal canal every few months, works to boost levels of the SMN protein, defects of which cause SMA.
Spinraza repeatedly shown to slow SMA progression in treated patients
Clinical trials have demonstrated that treatment with Spinraza can slow the progression of SMA, helping patients retain better motor function. Like other SMA treatments, Spinraza carries a hefty price tag, with a list price upward of $300,000 per year.
Biogen wanted to assess how treatment with Spinraza affects patients’ use of medical services, particularly inpatient hospitalization or trips to the emergency room, and costs associated with these services.
Using a U.S. insurance database, the study’s researchers identified data covering 103 people with SMA who started on Spinraza between 2016 (when it was first approved) and 2020. Among these patients, 59 were children younger than age 18; the remaining 44 patients were adults up to age 63. Slightly more than half had commercial health insurance, while the rest were insured through Medicaid, the government program that gives health insurance to low-income people in the U.S.
Researchers compared rates of inpatient hospital stays in the year before starting Spinraza to rates across the first year on the treatment. Results showed a significant decrease in hospital stays, by 41% for children and 67% for adults. The amount of time spent in the hospital also declined, by 11% across both age groups.
Consistently, costs associated with hospital stays also decreased. Among children, average costs associated with hospitalization declined from $22,903 to $8,466 per patient, a 63% decrease. A similar pattern was seen for adults, with average hospitalization costs decreasing by 79%, from $13,997 to $2,899 per patient.
68% decline in total hospitalization costs seen across year of use
Considering all patients collectively, total hospitalization costs decreased by 68% after starting Spinraza, from $1,967,121 to $627,063.
The total number of emergency department admissions also declined after patients started on Spinraza, by about 8% on average, and emergency-related costs consistently decreased by about 35% (from $120,069 to $77,938).
Researchers noted that, although rates of emergency admissions decreased among children, adults with SMA actually had more frequent emergency admissions over the year after starting with Spinraza. But emergency admissions among adults on Spinraza were “largely due to reasons not related to SMA,” the scientists said.
“The percentage of patients with ED [emergency department] visits related to SMA or its common comorbidities were low and only increased slightly for musculoskeletal problems,” they wrote.
Collectively, these data indicate that treatment with Spinraza “is likely to reduce the overall burden of SMA, including respiratory-related care administered in the inpatient setting in terms of frequency of admissions, time spent in the hospital and associated costs to the healthcare system,” the researchers concluded.
As this study is limited to a relatively small number of patients and only compared the year before and after starting on Spinraza, the scientists cautioned that its findings can’t be extrapolated to a patient’s lifetime. Still, they said these findings “can contribute to understanding the overall impact of [Spinraza] on patients with SMA, which may be of great importance to payers and policy makers.”
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