Economic burden of multiple sclerosis in a population with low physical disability

Abstract

Background In multiple sclerosis (MS), half of affected people are unemployed within 10 years of diagnosis. The aim of this study was to assess the economic impact of MS in adult subjects with relapsing-remitting MS (RRMS) and primary progressive MS (PPMS). Methods A multicenter, non-interventional, cross-sectional study was conducted. The Expanded Disability Status Scale (EDSS) and the 23-item Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ-23) were used to assess disability and work performance, respectively. Only indirect costs were considered using the human capital method, including work costs. Professional support costs and informal caregivers’ costs were also estimated. Results A total of 199 subjects were studied (mean age: 43.9 ± 10.5 years, 60.8% female, 86.4% with RRMS). Median EDSS score was 2.0 (interquartile range: 1.0–3.5) and median MSWDQ-23 total score was 31.5 (15.2, 50.0). The number of employed subjects decreased after MS diagnosis from 70.6 to 47.2%, and the number of retired people increased (23.6%). Mean age of retirement was 43.6 ± 10.5 years. Ten percent of the population had sick leaves (absenteeism was seen in 90.9% of the student population and 30.9% of the employed population). Professional support in their daily life activities was needed in 28.1% of subjects. Costs for sick leave, work absenteeism, premature retirement and premature work disability/pensioner were €416.6 ± 2030.2, €763.4 ± 3161.8, €5810.1 ± 13,159.0 and €1816.8 ± 9630.7, respectively. Costs for professional support and informal caregiving activities were €1026.93 ± 4622.0 and €1328.72, respectively. Conclusions MS is responsible for a substantial economic burden due to indirect and informal care costs, even in a population with low physical disability.

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“…One systematic review reported that annual indirect costs of MS per patient can range from US$2000 (when including sick leave, disability and workers’ compensation) to US$20,000 (when including costs of work time missed, underemployment and episodes of unemployment due to disability) [ 15 ]. Even individuals who experience only mild physical disability from MS have substantial costs associated with sick leave, work absenteeism and premature retirement [ 16 ]. Individuals with MS experience financial strain from reduced income due to missed work or early retirement.…”

“…Individuals with MS experience financial strain from reduced income due to missed work or early retirement. Employers are burdened by reduced productivity and workers’ compensation payments, while the economy suffers from labor force reductions and bears the costs of paying out disability benefits [ 12 , 15 , 16 ].…”

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“…Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system associated with disability progression and a high impact on patients' daily activities and quality of life (HRQoL) [1,2]. The cause of MS is unknown.…”

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“…Its prevalence has substantially increased in the last three decades and it affects ~2.3 million people worldwide ( 1 , 2 ). The disease is associated with a high economic burden for society, and Spain is the European country with the highest total annual cost per patient ( 3 , 4 ).…”