MSA is a rare progressive neurodegenerative disorder affecting central motor and autonomic function. It is estimated to affect less than 20,000 people in the United States (US). We examined the cost of care for MSA from the perspective of the US payer.

A retrospective cohort study was conducted using claims data from the Komodo Research Dataset (Komodo Health, Inc.). Patients with MSA were identified based upon two claims with an ICD-10 code of G23.2 or G23.3 at least 30 days apart between January 2021 and December 2023. Direct healthcare costs are reported for each calendar year. Costs were adjusted to 2024 US dollars using the Consumer Price Index for Medical Care.

We identified 408 people with MSA in 2021, 492 in 2022 and 436 in 2023. In 2023, the average age was 69 years (SD=14.9). 58% were male, and 79% were white. 71% had Medicare as their payer. The average Charlson Comorbidity Index score was 2.4. 46% had sleep disorders and 58% had mobility challenges.

The mean total annual cost of care per patient was $55,775 in 2021, $50,999 in 2022, and $62,086 in 2023. In 2023, outpatient services accounted for 46% of these costs, other costs (e.g., home health care) for 25%, and inpatient hospital care for 17%. In 2023, 58% of people living with MSA had at least one emergency department visit, and 33% had at least one inpatient visit during the year (median length of stay: 6 days). Of all inpatient visits in 2023, 31% included an ICU admission.

 To our knowledge, this is the first population-based study of cost of care and HCRU for people living with MSA. MSA places a substantial burden on families, payers and society.