The socioeconomic consequences of multiple sclerosis: A controlled national study

doi:10.1016/j.euroneuro.2011.05.001

European Neuropsychopharmacology

Volume 22, Issue 1, January 2012, Pages 36-43

https://doi.org/10.1016/j.euroneuro.2011.05.001 Get rights and content

Abstract

Multiple sclerosis (MS) has serious negative effects on health-, social-, and work-related issues for the patients and their families, thus causing significant socioeconomic burden.

The objective of the study was to determine healthcare costs and indirect illness costs in MS patient in a national sample.

We used all national records from the Danish National Patient Registry (1998–2006), and identified 10,849 MS patients which were compared with 43,396 randomly age-, sex- and social matched citizens. Healthcare sector costs included frequencies and costs of hospitalizations and weighted outpatient use, frequencies of visits and hospitalizations and costs from primary sectors, and the use and costs of drugs. Productivity costs (the value of lost productivity from time off from work due to illness) and all social transfer payments were also calculated.

Patients with MS had significantly higher rates of health-related contact and medication use and very low employment rate which incurred a higher socioeconomic cost. The income level of employed MS patients was significantly lower than that of control subjects. The annual total health sector costs and productivity costs were €14,575 for MS patients vs. €1163 for control subjects (p < 0.001), corresponding to an annual mean excess health-related cost of €13,413 for each patient with MS. In addition, the MS patients received an annual mean excess social transfer income of €6843. MS present social and economical consequences more than eight years before diagnosis.

We conclude that MS causes major socioeconomic consequences for the individual patient and for society. Productivity costs are a far more important economic factor, especially due to reduced employment, which are enhanced by the early age of diagnose onset.

Section snippets

Patients

In Denmark, all patient contacts with the healthcare system are recorded in the NPR at the time of contact and include the primary diagnosis. The NPR includes administrative information, diagnoses, and diagnostic and treatment procedures using several international classification systems, including the International Classification of Diseases (ICD-10). Thus, the NPR is a time-based national database that includes data from all patient contacts; therefore, the data that we identified are

Results

In total, 10,849 patients with MS were identified; their data were subsequently matched with data from 43,396 control subjects. The mean age was 48 years. Women constituted 66% of the population. The age distribution of patients and controls are presented in Table 1.

Discussion

In this study we evaluated the socioeconomic impact of MS, including the empirical healthcare costs and productivity costs, in a national sample with age- and sex-matched control subjects. This population-based study included all patients with a diagnosis of MS in Denmark during an 8-year period. Patients with MS had significantly higher rates of contacts with the healthcare system, which included all healthcare sectors: general practice, outpatient clinics, and in-hospital services. The

Role of the funding source

The study is supported from an unrestricted grant from Center for Healthy Aging (CEHA), University of Copenhagen. The study is part of Cost of Brain Diseases, European Brain Network (EBN). The CEHA and EBN have no further role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

Contributors

Poul Jennum is the principal investigator, designed the study, is the main author and did interpretation of the data. Jakob Kjellberg is a co-author, designed the study and performed the statistical analysis. Benedikte Wanscher and Jette Frederiksen commented the results and the manuscript. All authors contributed to and have approved the final manuscript.

Conflict of interest

None of the authors have reported any conflict of interests.

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View full text

The socioeconomic consequences of multiple sclerosis: A controlled national study

Abstract

Section snippets

Patients

Results

Discussion

Role of the funding source

Contributors

Conflict of interest

Clin. Neurol. Neurosurg.

Cost utility of drugs for multiple sclerosis. Systematic review places study in contrast

BMJ

Interferon-beta1a for the treatment of multiple sclerosis

Expert. Opin. Biol. Ther.

An Introduction to the Bootstrap

Use of intravenous immunoglobulin for treatment of neurologic conditions: a systematic review

Transfusion

Cost and health related quality of life consequences of multiple sclerosis

Mult. Scler.

The economics of multiple sclerosis. Distribution of costs and relationship to disease severity

PharmacoEconomics

Economic evaluation of Avonex (interferon beta-Ia) in patients following a single demyelinating event

Mult. Scler.

Economic evidence in multiple sclerosis: a review

Eur. J. Health Econ.

Cost of multiple sclerosis in Europe

Eur. J. Neurol.

Costs and quality of life in multiple sclerosis: a cross-sectional study in the United States

Neurology

Costs and quality of life of patients with multiple sclerosis in Europe

J. Neurol. Neurosurg. Psychiatry