Cost of illness in multiple sclerosis by disease characteristics – A review of reviews

Schriefer, Dirk; Haase, Rocco; Ness, Nils Henning; Ziemssen, Tjalf

doi:10.1080/14737167.2022.1987218

Cited by 13 publications

(22 citation statements)

References 170 publications

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“…The calculated costs also seem comparable in view of studies on patients with other chronic diseases associated with epilepsy or epilepsy syndromes, such as tuberous sclerosis complex (€1650 per month) 34,35 ; however, costs calculated in this study were significantly lower than costs of other chronic neurological diseases such as multiple sclerosis (MS; €3358 per month) and developmental and epileptic encephalopathies such as Dravet syndrome (DS; €3819 per month) 4,36 . These COI differences seem to be primarily attributable to the absence of progressive physical and mental disabilities in most patients with epilepsy compared to the frequent occurrence of disability in patients with MS or DS 37,38 . The total annual economic burden due to epilepsy has been estimated at €1.6 billion for Germany, whereby this is distributed over approximately 600 000 patients 39 .…”

Section: Discussionsupporting

confidence: 53%

“…4,36 These COI differences seem to be primarily attributable to the absence of progressive physical and mental disabilities in most patients with epilepsy compared to the frequent occurrence of disability in patients with MS or DS. 37,38 The total annual economic burden due to epilepsy has been estimated at €1.6 billion for Germany, whereby this is distributed over approximately 600 000 patients. 39 The total sum is comparable to €1.7 billion for patients with MS; however, this applies to 188 000 patients in Germany.…”

Section: Discussionmentioning

confidence: 99%

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Trends in resource utilization and cost of illness in patients with active epilepsy in Germany from 2003 to 2020

et al. 2022

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Trends in resource utilization and cost of illness in patients with active epilepsy in Germany from 2003 to 2020

et al. 2022

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“…This agrees with previous health economic studies where indirect costs of MS, including sickness absence, unemployment and early retirement rose with longer disease duration, greater disability and during relapse episodes. 33,34 A recent meta-analysis of cross-sectional studies documented that PwMS who are unemployed reported higher levels of disability. 25 We showed that every unit increase in EDSS at 5 years was associated with a 35%-95% increased risk of being in an early-deteriorated employment and/or workhours trajectory.…”

Section: Discussionmentioning

confidence: 99%

Long-term trajectories of employment status, workhours and disability support pension status, after a first episode of CNS demyelination

et al. 2022

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Background: People with multiple sclerosis face significant employment-related challenges, with little known of the drivers of these outcomes. Objective: We examined prospective trajectories of employment-related outcomes up to 11 years following a first episode of central nervous system (CNS) demyelination (FCD). Methods: Participants were aged 18–59 years, at FCD, with at least two observations and were employed at study entry or anytime during follow-up ( n = 207). Outcomes were employment status (full-time, part-time and unemployed), average workhours per week and disability support pension (DSP; receiving/not receiving). We used group-based trajectory modelling to identify groups with common trajectories. Factors associated with trajectory membership were explored using log-multinomial regression. Results: Distinct trajectories were identified for employment (4), workhours (4) and DSP (2). Compared with stable full-time, female sex was strongly associated with being in the stable part-time trajectory (risk ratio (RR): 5.35; 95% confidence interval (CI) = 2.56–11.20; p < 0.001). A greater level of disability at 5-year review (RR: 1.35; 95% CI = 1.19–1.53) and having more than two comorbidities at baseline (RR: 2.77; 95% CI = 1.37–5.64) were associated with being in early and late deteriorated employment trajectories, respectively. Compared with the increased part-time trajectory, every additional relapse during the 5 years post-FCD was associated with a 10% increased risk of being in the reduced part-time trajectory (RR = 1.10; 95%CI = 1.00–1.22). For every additional EDSS point at 5-year review, the risk of being in the DSP trajectory increased (RR = 1.21; 95% CI = 1.05–1.41). Conclusion: These trajectories indicate substantial heterogeneity and the complex impact of MS on employment from its earliest timepoints. Understanding these trends could enable better targeting of interventions to facilitate workforce retention, particularly for females, those with a higher number of comorbidities, more frequent relapses and greater rate of disability accrual.

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“…We strived to craft a valid valuation approach amid the financial and economic crisis by using recommended and validated methods used in COI studies, such as conducting a sensitivity analysis, adjusting costs for inflation, and reporting costs in PPP$. Several COI studies conducted sensitivity analyses [31][32][33][34][35] to explore different scenarios in estimating costs. Adjusting for inflation and converting local currencies to PPP$ are becoming a necessity within health economic studies [36,37] to enhance comparability of cost estimates collected from different countries in different years [4,35,38].…”

Section: Discussionmentioning

confidence: 99%

“…Several COI studies conducted sensitivity analyses [31][32][33][34][35] to explore different scenarios in estimating costs. Adjusting for inflation and converting local currencies to PPP$ are becoming a necessity within health economic studies [36,37] to enhance comparability of cost estimates collected from different countries in different years [4,35,38]. Additionally, the Cochrane Handbook [39] recommended presenting costs' results using the PPP while converting cost estimates of a target currency to a fixed price year.…”

Section: Discussionmentioning

confidence: 99%

Valuation of Costs in Health Economics During Financial and Economic Crises: A Case Study from Lebanon

Dahham

Kremer

Hiligsmann

et al. 2022

Appl Health Econ Health Policy

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In 2019, we embarked on a study on the economic burden of multiple sclerosis (MS) in Lebanon, in collaboration with a premier Lebanese MS center. This coincided with a triple disaster in Lebanon, comprising the drastic economic and financial crisis, the COVID-19 pandemic, and the consequences of the explosion of Beirut’s port. Specifically, the economic and financial turmoil made the valuation of costs challenging. Researchers could face similar challenges, particularly in low- and middle-income countries (LMICs) where economic crises and recessions are recurrent phenomena. This paper aims to discuss steps taken to overcome the fluctuation of the prices of resources to get a valid valuation of societal costs during times of a financial and economic crisis. In the absence of local costing data and guidelines for conducting cost-of-illness (COI) studies, this paper provides empirical recommendations on the valuation of costs that are particularly relevant in LMICs. We recommend (1) clear reporting and justification of the country-specific context, year of costing, assumptions, data sources, and valuation methods, as well as the indicators used to adjust cost for inflation during different periods of fluctuation of prices; (2) collecting prices of each resource from multiple and various sources; (3) conducting a sensitivity analysis; and (4) reporting costs in local currency and Purchasing Power Parity dollars (PPP$). Precision and transparency in reporting prices of resources and their sources are markers of the reliability of the COI studies.

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Cost of illness in multiple sclerosis by disease characteristics – A review of reviews

Cited by 13 publications

References 170 publications

Trends in resource utilization and cost of illness in patients with active epilepsy in Germany from 2003 to 2020

Trends in resource utilization and cost of illness in patients with active epilepsy in Germany from 2003 to 2020

Long-term trajectories of employment status, workhours and disability support pension status, after a first episode of CNS demyelination

Valuation of Costs in Health Economics During Financial and Economic Crises: A Case Study from Lebanon

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