Cost of multiple sclerosis in the Czech Republic: The COMS study

Dušánková, Jana Blahová; Kalinčík, Tomáš; Doležal, Tomáš; Kobelt, Gisela; Havrdová, Eva

doi:10.1177/1352458511424422

Cited by 36 publications

(45 citation statements)

References 17 publications

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“…In particular, cognitive impairment has recently been increasingly recognized as an important determinant of employment status and associated societal costs,5, 6 negatively impacting social functioning, coping, quality of life, and treatment adherence among patients with MS 7…”

Section: Introductionmentioning

confidence: 99%

Cognitive clinico‐radiological paradox in early stages of multiple sclerosis

Uher

Krásenský

Sobíšek

et al. 2017

Ann Clin Transl Neurol

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ObjectiveTo investigate whether the strength of the association between magnetic resonance imaging (MRI) metrics and cognitive outcomes differs between various multiple sclerosis subpopulations.MethodsA total of 1052 patients were included in this large cross‐sectional study. Brain MRI (T1 and T2 lesion volume and brain parenchymal fraction) and neuropsychological assessment (Brief International Cognitive Assessment for Multiple Sclerosis and Paced Auditory Serial Addition Test) were performed.ResultsWeak correlations between cognitive domains and MRI measures were observed in younger patients (age≤30 years; absolute Spearman's rho = 0.05–0.21), with short disease duration (<2 years; rho = 0.01–0.21), low Expanded Disability Status Scale [EDSS] (≤1.5; rho = 0.08–0.18), low T2 lesion volume (lowest quartile; <0.59 mL; rho = 0.01–0.20), and high brain parenchymal fraction (highest quartile; >86.66; rho = 0.01–0.16). Stronger correlations between cognitive domains and MRI measures were observed in older patients (age>50 years; rho = 0.24–0.50), with longer disease duration (>15 years; rho = 0.26–0.53), higher EDSS (≥5.0; rho = 0.23–0.39), greater T2 lesion volume (highest quartile; >5.33 mL; rho = 0.16–0.32), and lower brain parenchymal fraction (lowest quartile; <83.71; rho = 0.13–0.46). The majority of these observed results were confirmed by significant interactions (P ≤ 0.01) using continuous variables.InterpretationThe association between structural brain damage and functional cognitive impairment is substantially weaker in multiple sclerosis patients with a low disease burden. Therefore, disease stage should be taken into consideration when interpreting associations between structural and cognitive measures in clinical trials, research studies, and clinical practice.

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Section: Introductionmentioning

confidence: 99%

Cognitive clinico‐radiological paradox in early stages of multiple sclerosis

Uher

Krásenský

Sobíšek

et al. 2017

Ann Clin Transl Neurol

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“…The coefficient of variation, defined as standard deviation compared to the mean, was 0.15 and 0.38, for EDSS II and III, respectively, for all 12 studies including EDSS estimates of costs. Concerning the mildest severity categorization, hereafter called EDSS I, seven out of ten studies that specified costs per category identified MS treatment as the main cost driver [26,[37][38][39][40][41][42]. The cost driver varied more between studies in the moderate severity group, EDSS II, where it was identified as drugs or MS treatment [37,[39][40][41], permanent reductions in productive work [26,38,43], other classifications of indirect costs [57,58], and informal care [42].…”

Section: Resultsmentioning

confidence: 99%

“…The cost driver varied more between studies in the moderate severity group, EDSS II, where it was identified as drugs or MS treatment [37,[39][40][41], permanent reductions in productive work [26,38,43], other classifications of indirect costs [57,58], and informal care [42]. Four out of ten studies [38,[40][41][42] identified informal care as the main cost driver for individuals in the most severe group, EDSS III, whereas four studies identified production losses due to permanent reductions in productive work [26,37,39,43] and two identified other types of indirect costs [57,58].…”

Section: Resultsmentioning

confidence: 99%

“…In two of the included studies [24,25], results were presented in an alternate currency (Euro for non-Euro countries) and recalculations based on the exchange rates given in the articles were made in order to follow the principle of using PPP for each country. In two other studies [26,27], exchange rates were not reported, why the PPP rate for the EU area was chosen although this concerned non-euro countries. For studies not presenting annual costs, transformations were made to 12 months basis, assuming that there were no seasonal variations in resource use.…”

Section: Methodsmentioning

confidence: 99%

“…It has e.g., been argued that there might be contextual differences for patients with MS to rely on family members or on friends for informal care, which can also affect the calculated cost for informal care [51]. As the included studies categorized informal care as an unspecified direct cost [27,34,35,52,53], as a direct nonmedical cost [37][38][39][40][41][42][43][44][45][46][47][48][49][50][51]53], presented separately from direct and indirect costs [58] or, as an indirect cost [26,57], Included cost categories, as well as e.g., proportions will differ due to methodological choices.…”

Section: Methods Of Calculation Affects the Comparability Between Stumentioning

confidence: 99%

See 2 more Smart Citations

Cost of Illness of Multiple Sclerosis - A systematic review

Ernstsson

Gyllensten

Alexanderson

et al. 2015

European Journal of Public Health

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Future MS care: a consensus statement of the MS in the 21st Century Steering Group

et al. 2012

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The “MS in the 21st Century” initiative was established with the purpose of (1) defining how multiple sclerosis (MS) treatment and standards of care should look in the 21st century; (2) developing a minimum standard of care across the world; and (3) motivating the broad MS community to align standards of care and challenge the current treatment paradigm. The aim was to develop a consensus statement to reach and influence the broader MS community. An expert steering group from Europe and Canada—consisting of neurologists, patient advocates, a pharmacoepidemiologist/pharmacoeconomist, and representatives from national MS centers—participated in a series of workshop-driven meetings between February 2011 and 2012. After three phases of discussions, the steering group identified that the overall vision for future care of MS should be full access to personalized treatment, with reimbursement, to achieve freedom from disease. They constructed seven overall principles that support this vision: personalized care, patient engagement, commitment to research, regulatory body education and reimbursement issues, new endpoints in clinical trials, more therapy options, and MS centers of excellence. This consensus statement outlines the key aspects of the seven principles that need to be addressed. The “MS in the 21st Century Steering Group” hopes that this consensus statement acts as a call to action for healthcare providers and decision-makers to address simultaneously the overarching principles that will guide patient management in order to improve outcomes for people with MS.

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Cost of multiple sclerosis in the Czech Republic: The COMS study

Abstract: The total costs of MS in the Czech Republic are estimated at €208.6 million per year. Consistent with other studies, the costs increase significantly with the severity of MS.

Cited by 36 publications

References 17 publications

Cognitive clinico‐radiological paradox in early stages of multiple sclerosis

Cognitive clinico‐radiological paradox in early stages of multiple sclerosis

Cost of Illness of Multiple Sclerosis - A systematic review

Future MS care: a consensus statement of the MS in the 21st Century Steering Group

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