Highlights
- •NMOSD is associated with increased health care utilization and with a significant financial burden.
- •100 NMOSD patients from Argentina were included and AQP4-Ab and/or MOG-Ab testing were requested in 91% of patients.
- •Health insurance covered AQP4-Ab and/or MOG-Ab test partially in 15% of cases, but 33% of patients paid it in full of their own pocket.
- •Private insurance (OR=3.84, p=0.01) was the only factor independently associated with appropriate access to long-term NMOSD-specific medications.
Abstract
Introduction
Neuromyelitis optica spectrum disorder (NMOSD) is a rare but severe neuroimmunological
condition associated with a significant financial burden. NMOSD is also associated
with increased health care utilization, including neurology outpatient visits, magnetic
resonance imaging (MRI) use, long-term medication, among others. We aimed to evaluate
real-world patient experiences in access to care and NMOSD burden in an Argentinean
cohort.
Methods
This cross-sectional study used a self-administered survey and was conducted in Argentina
(2022). Patients with NMOSD were divided into three groups: private health insurance
(PHI), social health insurance (SHI), and public health insurance (PHI, Ministry of
Public Health). Differences in access and health care barriers were assessed.
Results
One hundred patients with NMOSD (74 women) with a mean age at diagnosis of 38.7 years
were included. Their EDSS was 2.8 and they were followed for 5.2 years. Of them, 51%,
11%, and 13% were employed (full-time: 57.5%), currently unemployed and retired by
NMOSD, respectively. 55% of them visited between 2-3 specialists before NMOSD diagnosis.
Aquaporin-4-antibody and/or myelin oligodendrocyte glycoprotein-antibody testing was
requested in 91% (health insurance covered this partially in 15.3% and 32.9% of the
time the test was entirely paid by patient/family). Patients with NMOSD receiving
private medical care reported greater access to MRI, outpatient visits, and fewer
issues to obtain NMOSD medications compared to those treated at public institutions.
A longer mean time to MRI and neurology visit was found in the PHI group when compared
with the other two subgroups. Regression analysis showed that private insurance (OR=3.84,
p=0.01) was the only independent factor associated with appropriate access to NMOSD
medications in Argentina.
Conclusion
These findings suggest that barriers to access and utilization of NMOSD care services
in Argentina are common. NMOSD patients experienced problems to receive NMOSD medication
properly, especially those from the public sector.
Keywords
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Article info
Publication history
Published online: December 24, 2022
Accepted:
December 22,
2022
Received in revised form:
December 3,
2022
Received:
September 26,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
