New insights into the burden and costs of multiple sclerosis in Europe

Mult Scler. 2017 Jul;23(8):1123-1136. doi: 10.1177/1352458517694432. Epub 2017 Feb 1.

Abstract

Background: The current focus in multiple sclerosis (MS) is on early diagnosis and drug intervention, with a view to modifying disease progression. Consequently, healthcare costs have shifted from inpatient care and rehabilitation to outpatient care.

Objectives: This European burden of illness study provides data that can be combined with other evidence to assess whether management approaches provide value to society.

Methods: A cross-sectional study was conducted in 16 countries. Patients reported on their disease, health-related quality of life (HRQoL) and resource consumption. Descriptive analyses were performed by disease severity. Costs are reported from a societal perspective in 2015€ PPP (adjusted for purchasing power parity).

Results: The 16,808 participants had a mean age of 51.5 years, and 52% had relapsing-remitting multiple sclerosis (RRMS). Work capacity declined from 82% to 8%, and utility declined from normal population values to less than zero with advancing disease. Mean costs were 22,800€ PPP in mild, 37,100€ PPP in moderate and 57,500€ PPP in severe disease; healthcare accounted for 68%, 47% and 26%, respectively. Fatigue and cognitive difficulties were reported by 95% and 71% of participants, respectively; both had a significant independent effect on utility.

Conclusion: Costs and utility were highly correlated with disease severity, but resource consumption was heavily influenced by healthcare systems organisation and availability of services.

Keywords: HRQoL; Multiple sclerosis; burden of illness; cognition; costs; fatigue.

MeSH terms

  • Adult
  • Ambulatory Care / economics
  • Cost of Illness
  • Disease Progression
  • Europe
  • Female
  • Health Care Costs / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / economics*
  • Multiple Sclerosis / epidemiology
  • Multiple Sclerosis / therapy
  • Quality of Life*
  • Recurrence
  • Severity of Illness Index