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Economic Costs of Myasthenia Gravis: A Systematic Review


  • Erik Landfeldt

    (Karolinska Vägen 37A)

  • Oksana Pogoryelova

    (Absolute Antibody Ltd., Wilton Centre)

  • Thomas Sejersen

    (Karolinska Vägen 37A)

  • Niklas Zethraeus

    (Karolinska Institutet)

  • Ari Breiner

    (University of Ottawa)

  • Hanns Lochmüller

    (University of Ottawa
    Medical Centre-University of Freiburg, Faculty of Medicine
    University of Ottawa)


Objectives The objective of our study was to conduct a systematic literature review of economic costs (henceforth costs) associated with myasthenia gravis (MG). Methods We searched MEDLINE (through PubMed), CINAHL, Embase, PsycINFO, and Web of Science for studies reporting costs of MG published from inception up until March 18, 2020, without language restrictions. Two reviewers independently screened records for eligibility, extracted the data, and assessed included studies for risk of bias using the Newcastle–Ottawa Scale. Costs were inflated and converted to 2018 United States dollars ($). Results The search identified 16 articles for data extraction and synthesis. Estimates of costs of MG were found for samples from eight countries spanning four continents (Europe, North America, South America, and Asia). Across studies, the mean per-patient annual direct medical cost of illness was estimated at between $760 and $28,780, and cost per hospitalization between $2550 and $164,730. The indirect cost of illness was estimated at $80 and $3550. Costs varied considerably by patient characteristics, and drivers of the direct medical cost of illness included intravenous immunoglobulin and plasma exchange, myasthenic crisis, mechanical ventilatory support, and hospitalizations. Conclusions We show that the current body of literature of costs of MG is sparse, limited to a few geographical settings and resource categories, mostly dated, and subject to non-trivial variability, both within and between countries. Our synthesis will help researchers and decision-makers identify gaps in the local health economic context of MG and inform future cost studies and economic evaluations in this patient population.

Suggested Citation

  • Erik Landfeldt & Oksana Pogoryelova & Thomas Sejersen & Niklas Zethraeus & Ari Breiner & Hanns Lochmüller, 2020. "Economic Costs of Myasthenia Gravis: A Systematic Review," PharmacoEconomics, Springer, vol. 38(7), pages 715-728, July.
  • Handle: RePEc:spr:pharme:v:38:y:2020:i:7:d:10.1007_s40273-020-00912-8
    DOI: 10.1007/s40273-020-00912-8

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    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 29th June 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-06-29 11:00:06


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    Cited by:

    1. Anil babu Payedimarri & Matteo Ratti & Riccardo Rescinito & Alessandra Vasile & Deborah Seys & Hervé Dumas & Kris Vanhaecht & Massimiliano Panella, 2021. "Development of a Model Care Pathway for Myasthenia Gravis," IJERPH, MDPI, vol. 18(21), pages 1-14, November.

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