OBJECTIVES: To describe the secondary healthcare resource use in England for patients with Myasthenia Gravis (MG).

METHODS: A retrospective observational cohort study using Hospital Episode Statistics (HES) between 30^th June 2014 and 30^th June 2021. Included patients were ≥18 years at the index MG diagnosis (ICD-10). Healthcare resource use was described by the total and mean (SD) number of hospital admissions/attendances per year and related costs during the patients’ follow-up period. Rescue therapies include intravenous immunoglobulin (IVIg), plasma exchange (PLEX) and rituximab.

RESULTS: A total of 9087 patients with MG were included, 53.1% of the cohort were male, mean (SD) age at index date was 66.54 (16.7) years, 83.8% of the patients were ≥50 years old at index date. Mean follow-up time for total patients with MG was 3.0 (SD 1.6) years). MG was first recorded at inpatient hospitalisation for 89.5% of patients and 10.5% in outpatient. Overall, MG accounted for 36,621 inpatient admissions; at 6 months post diagnosis the mean number of inpatient admissions per year was 4.9 (7.3) vs all follow-up 1.8 (5.4 SD). Rescue therapy was required in 13.2% (n=1208) of patients. Of these 6.9%, 1.4%, and 0.8% of the patients had ≥3 annual treatment with IVIg, PLEX and rituximab respectively. The cumulative cost of admission (excluding drug cost) for patients treated with IVIg (n=599) was £907,071.70.

CONCLUSIONS: In the UK myasthenic crisis and disease exacerbation in MG are associated with significant healthcare resource utilisation and frequently require inpatient hospitalisation, particularly in the first year after diagnosis. Newly diagnosed MG patients had more inpatient hospitalisation in the first year after diagnosis. Up to 90% received a MG diagnosis during hospitalisation. In addition, around 13.2% of MG patients need rescue therapy, over and above the first line medications for MG.