Differences in treatment and health care costs for Duchenne muscular dystrophy (DMD) exist among racial and ethnic groups, found a study published recently in the Journal of Managed Care and Specialty Pharmacy.
White patients had the highest health care expenses, averaging $108,895 annually, compared with $59,501 for Black patients, $61,199 for Hispanic patients, and $65,247 for those of other or unknown backgrounds. Researchers suggest that these differences were largely driven by higher use of exon-skipping therapies among White patients, a costly but effective treatment for certain genetic mutations in DMD.
“White patients were most likely to have a claim for an angiotensin receptor blocker, whereas Hispanic patients were most likely to have a claim for deflazacort in the follow-up period,” the authors wrote. “White patients also had the highest all-cause and DMD-related health care costs, largely because of the high cost of exon-skipping therapies.”
This study analyzed Medicaid data from 561 male patients under 40 years old diagnosed with DMD between 2017 and 2021. White patients comprised 64.2% of the study population, while 8.9% were Black, 5.9% were Hispanic, and 21.0% were of other or unknown race and ethnicity. Despite some variation in age at diagnosis, clinical characteristics were generally similar across all groups. However, treatment patterns differed, with corticosteroids being the most commonly used therapy. Hispanic patients had the highest corticosteroid use at 73%, while Black patients had the lowest at 52%.
Read more about DMD treatment and care
Exon-skipping therapies, which target specific genetic mutations to slow progression of disease, were rarely used overall, with just 3% of patients receiving them. However, White patients had the highest usage at 4.2%, compared with lower rates in other racial and ethnic groups. These medications contributed to the significant difference in health care costs, as they are among the most expensive treatments available for DMD.
Health care resource utilization, including hospital admissions, outpatient visits and medication costs, varied but did not show statistically significant differences between groups. The majority of costs in the follow-up period were attributed to outpatient pharmacy expenses, reinforcing the impact of prescription drug use on overall spending. Researchers noted that disparities in access to exon-skipping therapies could be a key factor influencing cost variations.
“The racial differences seen in this study warrant additional research, especially with regards to differences in utilization of exon-skipping therapies,” the authors wrote.
Sign up here to get the latest news, perspectives and information about DMD sent directly to your inbox. Registration is free and only takes a minute.
