{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:29:02Z","timestamp":1792114142598,"version":"4.4.0"},"reference-count":38,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T00:00:00Z","timestamp":1728432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015661","name":"UCB Pharma","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015661","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Health care resource utilization (HCRU) and the economic burden of myasthenia gravis (MG) are significant, but existing studies rarely include comprehensive nationwide data. We examined HCRU and direct and indirect costs associated with MG overall and by disease severity in Denmark, Finland, and Sweden.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were collected retrospectively from nationwide health and social care registries. All individuals \u226518\u2009years of age with \u22652 International Classification of Diseases diagnoses of MG between 2000 and 2020 were included. HCRU, direct (inpatient and outpatient contacts, medication) and indirect costs (early retirement, sick leave, death), and associated factors were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The full study cohort comprised 8622 people with MG (pwMG). Mean annual numbers of all\u2010cause secondary health care contacts for pwMG were 3.4 (SD\u2009=\u20098.3), 7.0 (SD\u2009=\u200912.3), and 2.9 (SD\u2009=\u20093.9), with mean annual total costs of \u20ac12,185, \u20ac9036, and \u20ac5997 per person in Denmark, Finland, and Sweden, respectively. Inpatient periods, involving 77%\u201389% of study participants in the three countries, contributed most to direct costs, whereas the majority of indirect costs resulted from early retirement in Denmark and Finland, and sick leave periods in Sweden. Mean annual total costs were highest with very severe MG (\u20ac19,570\u2013\u20ac33,495 per person across the three countries). Female sex and comorbidities, such as mental and behavioral disorders and severe infections, were also associated with higher total costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This population\u2010based study shows a high level of HCRU and a significant direct and indirect economic burden of MG across three Nordic countries, especially for severe forms of MG.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16511","type":"journal-article","created":{"date-parts":[[2024,10,9]],"date-time":"2024-10-09T03:14:05Z","timestamp":1728443645000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Economic and societal burden of myasthenia gravis in Denmark, Finland, and Sweden: A population\u2010based registry study"],"prefix":"10.1111","volume":"31","author":[{"given":"Fredrik","family":"Piehl","sequence":"first","affiliation":[{"name":"Department of Clinical Neuroscience Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Neurology Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Vissing","sequence":"additional","affiliation":[{"name":"Department of Neurology, Copenhagen Neuromuscular Center Rigshospitalet, University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juha","family":"Meht\u00e4l\u00e4","sequence":"additional","affiliation":[{"name":"MedEngine Oy  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrik","family":"Berggren","sequence":"additional","affiliation":[{"name":"UCB Pharma  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6549-6065","authenticated-orcid":false,"given":"Ingrid","family":"Lindberg\u2010Schager","sequence":"additional","affiliation":[{"name":"UCB Pharma  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Pitsi","sequence":"additional","affiliation":[{"name":"UCB Pharma  Brussels Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6513-5886","authenticated-orcid":false,"given":"Evangelos","family":"Tsitlakidis","sequence":"additional","affiliation":[{"name":"Significance Consulting  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aino","family":"Vesikansa","sequence":"additional","affiliation":[{"name":"MedEngine Oy  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2228-3005","authenticated-orcid":false,"given":"Riina\u2010Minna","family":"V\u00e4\u00e4n\u00e4nen","sequence":"additional","affiliation":[{"name":"MedEngine Oy  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tero","family":"Ylisaukko\u2010oja","sequence":"additional","affiliation":[{"name":"MedEngine Oy  Helsinki Finland"},{"name":"MedEngine DK ApS  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sari","family":"Atula","sequence":"additional","affiliation":[{"name":"Clinical Neurosciences, Neurology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0079-y"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.8206.1"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2023-333097"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011124"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.16229"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000001196"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2023.e16367"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/17562864221150327"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/17562864241237495"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.822909"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-009-5256-6"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2016.11.003"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-016-0757-2"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-020-00912-8"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.16233"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1159\/000538640"},{"key":"e_1_2_10_18_1","unstructured":"Befolkningstal. 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