Health-related outcomes, health care resource utilization, and costs of multiple sclerosis in Japan compared with US and five EU countries

Abstract

PurposeMultiple sclerosis (MS) imposes a huge burden on patients. This study examined the relationship between MS and health-related and economic burden in Japan; secondarily, health status was compared across patients with MS in Japan, US, and five European Union (5EU) countries (France, Germany, Italy, Spain, and UK).MethodsA retrospective cross-sectional study was conducted using self-reported data from 2009 to 2014 Japan National Health and Wellness Survey (n=145,759). Health status, work productivity loss, activity impairment, health care resource utilization, and annual costs associated with MS (n=85) were compared with controls without MS (n=145,674). Propensity score matching and multivariable linear regressions determined the effect of MS after controlling for confounders. Health status in Japan was also compared with that of 5EU (n=62) and US (n=67) patients with MS.ResultsPatients with MS in Japan reported significantly worse health status via mental component summary score (MCS; 40.1 vs 45.8) and physical component summary score (PCS; 41.4 vs 51.2) and health state utility scores (0.63 vs 0.74; all P<0.001). They also reported more absenteeism (12.0% vs 3.7%), presenteeism (33.8% vs 19.8%), overall work impairment (40.9% vs 21.6%), and activity impairment (43.6% vs 24.0%), with higher indirect costs (¥2,040,672/US $20,102 vs ¥1,076,306/US$10,603) than controls (all P<0.001). Patients with MS reported higher resource use, including provider visits (8.0 vs 4.7), emergency room visits (0.03 vs 0.1), and hospitalizations (2.7 vs 0.69) in the past 6 months, with higher direct costs (¥3,670,906/US$36,162 vs ¥986,099/US$9,714) than controls (all P<0.001). Finally, Japanese patients with MS reported lower MCSs and higher PCSs than their US and 5EU counterparts.ConclusionMS in Japan is associated with poor health status and high work productivity loss, resource use, and costs, underscoring the need for improved treatment, especially vis-à-vis mental health, when comparing Japanese patients with their 5EU and US counterparts.

Socioeconomic consequences of multiple sclerosis—A systematic literature review

“…29 Also, the respective proportion were very different, for example in Japan absenteeism was 12% in MS and 3.7% in general population, whereas presenteeism-33.8% and 19.8%, respectively. 19 Similarly, in another Japanese study, 33 absenteeism proportions were 17.5% and 5.57%, respectively, and for presenteeism-38.11 and 21.62%, respectively.…”

“…37 However, the exact way of measurement may differ, for example Castelo-Branco et al calculated labour-force absenteeism as the mean annual prevalence and number of sick-leave and disability pension days, 38 whereas Ivanova et al looked at medically related absenteeism as work absences due to the use of medical services. 29 However, the two Japanese studies, 19,33 included in our review, did not specifically defined these types of outcomes, but did report higher proportions of both absenteeism and presenteeism in MS patients than controls. Glanz et al suggest that absenteeism and presenteeism may be measuring separate dimensions of the impact of health problems on work productivity.…”

“…5. Educational level: the proportion of those having school/high-school/university education 11,12,16,19,22,24,26,27,32. …”

Association of Multiple Sclerosis Phenotypes with Single Nucleotide Polymorphisms of IL7R, LAG3, and CD40 Genes in a Jordanian Population: A Genotype-Phenotype Study

“…MS is a global public health issue posing socio-economic and life quality challenges [5,20]. Although MS is an idiopathic disease, the epidemiology study refers to environmental and genetic factors underlying susceptibility to MS [21]. MS is usually a T-cell-mediated disease where activated T cells play a key role in the pathogenesis of this disease [22,23].…”

Systematic review and network meta‐analysis comparing ofatumumab with other disease‐modifying therapies available in Japan for the treatment of patients with relapsing multiple sclerosis

“…The burden of MS in Japan is substantial, with the medical cost per patient per days exceeding Parkinson's disease, myasthenia gravis, and rheumatoid arthritis, and this cost having increased between 2008 and 2016 5,6 . Japanese patients reported worse health status than patients in the United States (US) and European Union (EU) 7,8 …”