# Global Economic Burden of Spinal Muscular Atrophy: A Systematic Literature Review

## TL;DR

This study reviews the global economic impact of spinal muscular atrophy, highlighting high costs and the need for standardized evaluation methods.

## Contribution

The study provides a systematic analysis of the economic burden across SMA subtypes, emphasizing the need for standardized evaluation approaches.

## Key findings

- The weighted average annual cost for an SMA patient is US$109,906, with type 1 patients having the highest direct medical costs.
- Non-medical costs and caregiver productivity losses are significant, with 2,947 hours of caregiving required annually.
- The study highlights the heterogeneity of economic data and the need for standardized approaches to evaluate SMA's financial impact.

## Abstract

Spinal muscular atrophy (SMA) is a rare inherited neuromuscular disease classified into four main subtypes and characterized by severe muscle weakness and loss of motor function. Its high mortality rates, high treatment costs, and lengthy care requirements place a heavy burden on patients, caregivers, and the healthcare system. This study aims to explore the economic burden of SMA subtypes by analyzing costs, healthcare resource use, and loss of productivity for patients and their caregivers.

We conducted a systematic literature review, searching for studies published since 2010 via Medline, Embase, Google Scholar, and gray literature databases. We extracted data concerning costs, healthcare resources, and productivity losses among SMA subtypes. The quality of the included studies was assessed using the Newcastle-Ottawa Scale and the Quality of Health Economic Studies tools.

We retrieved 55 studies from 32 countries with economic data variation due to the study design, location, and SMA subtype. The weighted average annual cost for an SMA patient was US$109,906 with the highest costs observed in type 1 patients, who incurred direct medical costs without disease-modifying treatments of US$187,88. The non-medical costs accounted for US$109,379 per patient, along with frequent hospitalizations and high caregiver productivity losses, requiring 2,947 hours of caregiving annually.

The direct and indirect costs of SMA are substantial. The necessity for standardized approaches to evaluate and analyze the economic impact across various SMA subtypes is highlighted by the heterogeneity of the data. In order to control the financial burden of SMA, governments and healthcare systems can benefit from these insights to develop policies aimed at improving financial sustainability and patient support.