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The Economics of Multiple Sclerosis

Distribution of Costs and Relationship to Disease Severity

  • Review Article
  • Economics of Multiple Sclerosis
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Abstract

The introduction of expensive disease-modifying agents for the treatment of multiple sclerosis (MS) has created the potential for patients with MS to become higher contributors to healthcare spending. In an attempt to make formulary and reimbursement choices for these agents, decision-makers may look to the literature for guidance. This critical review attempts to decipher a consistent message from the available economic literature regarding the relationship between disease severity and cost in MS. In the 2 studies that have examined MS disease severity, a positive correlation with total (direct and indirect) cost, indirect cost and some, if not all, components of direct cost was reported. In studies taking the societal perspective, the majority of total costs were indirect. This paper documents the high burden of MS on society and serves to guide the decision-maker in interpreting the MS economic literature such that this information can be optimally utilised to make informed resource allocation decisions.

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References

  1. Weinshenker BG, Rice GPA, Noseworthy JH, et al. The natural history of multiple sclerosis: a geographically based study. IV: applications to planning and interpretation of clinical therapeutic trials. Brain 1991; 117: 1057–67

    Article  Google Scholar 

  2. Sadovnick AD, Ebers GC. Epidemiology of MS: a critical overview. Can J Neurol Sci 1993; 20: 17–29

    PubMed  CAS  Google Scholar 

  3. Dalmady-Israel C. Multiple sclerosis. In: DiPiro JT, Talbert RL, Yee GC, et al., editors. Pharmacotherapy: a pathophysiologic approach. 3rd ed. Stamford (CT): Appleton & Lange, 1997: 1167–77

    Google Scholar 

  4. Matthews WB, editor. McAlpine’s multiple sclerosis. 2nd ed. New York (NY): Churchill Livingstone, 1991

    Google Scholar 

  5. Johnson KP, Brooks BR, Cohen JA. Copolymer 1 reduces relapse rate and improves disability in relapsing-remitting multiple sclerosis: results of a phase III multicenter, double-blind, placebo-controlled trial. Neurology 1995; 45: 1268–76

    Article  PubMed  CAS  Google Scholar 

  6. Paty DW, Li DKB, UBC MS/MRI Study Group, IFNB Multiple Sclerosis Study Group. Interferon beta-1b is effective in relapsing- remitting multiple sclerosis. II: MRI analysis results of a multicenter, randomized, double-blind placebo-controlled trial. Neurology 1993; 43: 662–72

    Article  PubMed  CAS  Google Scholar 

  7. IFNB Multiple Sclerosis Study Group. Interferon beta-1b is effective in relapsing-remitting multiple sclerosis: clinical results of a multicenter, randomized, double-blind, placebo-controlled trial. Neurology 1993; 43: 655–61

    Article  Google Scholar 

  8. Gonsette, RE. Guidance on new therapies in MS patients [letter]. Lancet 1996; 348: 136

    Article  PubMed  CAS  Google Scholar 

  9. Inman RP. Disability indices, the economic costs of illness, and social insurance: the cost of MS. Acta Neurol Scand Suppl. 1984; 705: 46–55

    Google Scholar 

  10. Bourdette DN, Prochazka AV, Mitchell W, the VA Multiple Sclerosis Rehabilitation Study Group, et al. Health care costs of veterans with multiple sclerosis: implications for the rehabilitation of MS. Arch Phys Med Rehabil 1993; 74: 26–31

    PubMed  CAS  Google Scholar 

  11. Lechtenberg R. Multiple sclerosis fact book. Philadelphia (PA): FA Davis, 1988

    Google Scholar 

  12. Holmes BA, Madgwick T, Bates D. The cost of MS. Br J Med Econ 1995; 8: 181–93

    Google Scholar 

  13. Blumhardt LD, Wood C. The economics of MS: a cost of illness study. Br J Med Econ 1996: 10: 99–118

    Google Scholar 

  14. Bradley EM, Thompson RP, Wood PHN. The prevalence and severity of major disabling conditions: a reappraisal of the government social survey on the handicapped and impaired in Great Britain. Int J Epidemiol 1978; 7: 175–81

    Article  Google Scholar 

  15. Asche CV, Ho E, Chan B, et al. Economic consequences of MS for Canadians. Acta Neurol Scand 1997; 95: 268–74

    Article  PubMed  CAS  Google Scholar 

  16. Health Canada. National expenditures in Canada: 1975-1993. Ottawa (ON): Supply and Services Canada, 1994. Catalogue no.: H21–99

    Google Scholar 

  17. Statistics Canada. Income distributions by size in Canada, 1993. Ottawa (ON)0: Statistics Canada, Household Surveys Division, 1994. Catalogue no.: 13–207

    Google Scholar 

  18. Ontario Ministry of Health. Ontario health survey (OHS) user’s guide. Vol 2: Microdata manual. Toronto (ON): Queen’s Printer, 1993

    Google Scholar 

  19. Sketris IS, Brown M, Murray TJ, et al. Drug therapy in multiple sclerosis: a study of Nova Scotia Senior Citizens. Clin Ther 1996; 18 (2): 303–18

    Article  PubMed  CAS  Google Scholar 

  20. Brown MG, Murray TJ, Fisk JD, et al. A therapeutic and economic assessment of interferon beta in multiple sclerosis. Halifax (NS): Dalhousie Multiple Sclerosis Research Unit, 1996

    Google Scholar 

  21. Runmarker B, Andersen O. Prognostic factors in a multiple sclerosis incidence cohort with twenty-five years of follow-up. Brain 1993; 116: 117–64

    Article  PubMed  Google Scholar 

  22. IFNB Multiple Sclerosis Study Group, University of British Columbia, MS/MRI Analysis Group. Interferon beta-1b in the treatment of multiple sclerosis: final outcome of the randomized controlled trial. Neurology 1995; 45: 1277–85

    Article  Google Scholar 

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Grudzinski, A.N., Hakim, Z., Cox, E.R. et al. The Economics of Multiple Sclerosis. Pharmacoeconomics 15, 229–240 (1999). https://doi.org/10.2165/00019053-199915030-00003

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  • DOI: https://doi.org/10.2165/00019053-199915030-00003

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