Health economic aspects have been increasingly important during introduction of new treatments for multiple sclerosis. As a partial response for Norway, a cost-of-illness study was carried out to estimate the yearly cost of the illness to society and relate costs and patients’ quality of life to illness severity. Estimated cost to society was Euro 439 million in 2002 exclusive of the cost of reduced quality of life. The cost per patient was close to Euro 65,000. Account taken of methodological differences, the results compare to results for Sweden, Norway’s closest neighboring country. The illness reduced patients’ quality of life with 0.26. More patients were early retired because of their MS in Norway than in any of nine other European countries comprised by a recent European study, illustrating a liberal practice in Norway. The Norwegian cost of unpaid assistance was almost identical to the Swedish cost that was the lowest found across the countries in the European study. When related to illness severity, the cost per patient increased, and the patients’ experienced quality of life decreased with increasing EDSS levels in line with what has been found for other countries. Cost-of-MS studies have been carried out for a number of countries. Together they contribute to our understanding of the economic consequences of multiple sclerosis and, if their results are related to illness severity, also provide valuable information for further economic analyses of treatment and medication. Our study adds to this.
The economic costs of MS impose a heavy burden on the patients and their families. Supplementing the information on the cost of MS to society, our finding should be included as background information in decisions on reimbursing and allocating public resources for the well-being of MS patients and their families.
The research question initially formulated for this study was to attempt to set a numerical target for the total yearly cost of MS to the Norwegian society, and relate the cost and patients´ experienced quality of life to illness severity. As work progressed, the question of how much confidence may be put in this kind of information in Norway as for today turned into another main issue. It turned out that much of the information that could be used for our study was so imprecise or unreliable that giving an impression that the information could be used to give an acceptably precise single estimate of the cost of MS to the Norwegian society would be seriously misleading. Therefore both "conservative" and "best" estimates are given. A conservative estimate of the yearly cost of MS to the Norwegian society around year 2002 is NOK 1 836 million. A best estimate is NOK 4 033 million, more than twice the conservative estimate. Mainly three factors account for the difference between the estimates: Uncertainty on what elements should be included in cost-of-illness studies, uncertainty on how some cost elements should be valued, and a combination of differences in information on the same phenomena in different sources of information and the researchers´ choices on how to handle them. For decision making purposes the combined effect of differences in information from different sources and the researchers´ choices on how to handle them is most grave since it will usually go unrecognized.
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