Objective: To determine amyotrophic lateral sclerosis (ALS)-associated costs incurred by patients covered by Medicare and/or commercial insurance before, during and after diagnosis and provide cost details. Methods: Costs were calculated from the Medicare Standard Analytical File 5% sample claims data from Parts A and B from 2009, 2010 and 2011 for ALS Medicare patients aged ‰¥70 years (monthly costs) and ‰¥65 years (costs associated with disability milestones). Commercial insurance patients aged 18€“63 years were selected based on the data provided in the Coordination of Benefits field from Truven MarketScan® in 2008€“2010. Results: Monthly costs increased nine months before diagnosis, peaked during the index month (Medicare: $10,398; commercial: $9354) and decreased but remained high post-index. Costs generally shifted from outpatient to inpatient and private nursing after diagnosis; prescriptions and durable medical equipment costs were much higher for commercial patients post-diagnosis. Patients appeared to progress to disability milestones more rapidly as their disease progressed in severity (14.4 months to non-invasive ventilation [NIV] vs. 16.6 months to hospice), and their costs increased accordingly (NIV: $58,973 vs. hospice: $76,179). Conclusions: For newly diagnosed ALS patients in the U.S., medical costs are substantial and increase rapidly and substantially with each disability milestone.
Medical Subject Headings
Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
Digital Object Identifier (DOI)
Meng, Lisa; Bian, Amy; Jordan, Scott; Wolff, Andrew; Shefner, Jeremy M.; and Andrews, Jinsy, "Profile of Medical Care Costs in Patients With Amyotrophic Lateral Sclerosis in the Medicare Programme and Under Commercial Insurance" (2018). Neurology. 162.