Objective: To assess the direct healthcare costs and healthcare resource utilization (HCRU) of MSA in the US commercially insured population.

Background: MSA is a rare, rapidly progressive neurodegenerative disorder characterized by relentless functional decline, severe disability, and premature mortality. People with MSA (PwMSA) currently have access only to largely ineffective symptomatic treatments, with no treatments approved for MSA.

Method: Using an US administrative healthcare claims database (IQVIA PharMetrics® Plus), this observational study compared HCRU and direct healthcare costs for PwMSA (≥2 ICD-10 diagnoses of G23.2, G23.9, or G90.3 during the study period) versus costs for people with PD (PwPD; ICD-10 G20) over a 12‑month follow‑up period anchored to the first recorded MSA/PD claim (made between October 2016–June 2023). Costs were estimated using a linear mixed effects model accounting for patient-level clustering and expressed in Q2 2025 US Dollars.

Results: Mean (SE) total healthcare costs for PwMSA in the year after diagnosis were US$39,412 (970), comprising total medical costs of $28,171 (828) [outpatient: $11,337 (322); inpatient: $16,300 (704); emergency room (ER): $674 (49); urgent care: $24 (2)], and pharmacy costs of $11,000 (391). The mean out‑of‑pocket medical costs paid by PwMSA in the year after diagnosis were $6,620 (408). Compared to PwPD, PwMSA incurred S$12,157 [95% CI: $10,219, $14,095] higher mean total costs in the year following diagnosis, driven primarily by significantly higher medical (+$ 8,605 [$6,947, $10,264]) and pharmacy (+$3,290 [$2,527, $4,054]) costs (all p<0.01). HCRU, including the mean frequency of outpatient visits, ER visits, and days spent in inpatient facilities in the year following diagnosis were also significantly higher among PwMSA compared to PwPD (+8.1 visits, +0.5 visits, and +4.1 days, respectively, all p<0.01).

Conclusion: The significantly higher costs and HCRU observed among PwMSA compared with PwPD underscore the substantial economic burden associated with MSA. Elevated inpatient, outpatient, emergency, and pharmacy costs highlight the intensive care requirements associated with this rapidly progressive disorder, emphasizing the urgent unmet need for effective therapies.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/healthcare-resource-utilization-and-costs-of-multiple-system-atrophy-in-the-united-states-an-observational-database-study/