Impact of multiple sclerosis phenotypes on burden of disease in Finland

Abstract

Aims: The aim of this study was to quantify how multiple sclerosis (MS) phenotypes differ from each other in respect of costs and quality-of-life. Materials and methods: The study is based on survey data from Finnish patients with MS (n ¼ 553). The information contained disease type, disease severity according to self-reported Expanded Disease Severity Scale (EDSS), healthcare resource use, and medication use. In addition, information related to employment and early retirement was collected. EQ-5D-VAS and Multiple Sclerosis Impact Scale-29 (MSIS-29) instruments were used to collect quality-of-life data, and Fatigue Severity Scale (FSS) instrument for evaluating fatigue. Patients were stratified based on their disease type (relapsing-remitting MS (RRMS), secondary progressive MS (SPMS), primary progressive MS (PPMS)) and disease severity. The data were primarily analyzed using summary statistics. Results: SPMS had the highest annual total cost (71,177e) followed by PPMS (51,082e) and RRMS (36,492e). Early retirement covered the greatest share of costs in RRMS (39%) and SPMS (43%). In PPMS, early retirement and professional care were the two most equally important cost drivers, contributing together 56% of the total costs. Direct healthcare costs were responsible for 33%, 19%, and 18% of total costs in RRMS, SPMS, and PPMS. The mean EDSS in RRMS, SPMS, and PPMS were 2.5, 5.5, and 5.9, respectively. Differences in the quality-of-life were observed with both disease specific (MSIS-29) and generic (EQ-5D-VAS) instruments. The mean utility value from EQ-5D among patients with RRMS, SPMS, and PPMS was 0.76, 0.52, and 0.49, respectively. In addition, patients with SPMS and PPMS were more likely to report fatigue than patients with RRMS. Conclusions: MS phenotype has an impact on costs and quality-of-life of the patients. Early retirement seems to be one of the most important contributors to MS-related costs.

Epidemiology of multiple sclerosis in Central Europe, update from Hungary

“…The new phenotypic classification gives pivot to clinicians to assess the disease activity of their patients and to choose the most suitable DMT for them, also when to change, recognize if a given treatment has become inefficient. Recently published data shows that the biggest socioeconomical and financial burden on a society and healthcare giver is put on by the secondary progressive MS population, almost double that of the relapsing–remitting population (Purmonen, Hakkarainen, Tervomaa, & Ruutiainen, 2020). The majority, roughly 2/3rd of the total expense, fell into the categories of direct nonmedical costs and productivity loss, driven mainly by the early retirement of patients with secondary progressive disease (Purmonen et al, 2020).…”

“…Recently published data shows that the biggest socioeconomical and financial burden on a society and healthcare giver is put on by the secondary progressive MS population, almost double that of the relapsing–remitting population (Purmonen, Hakkarainen, Tervomaa, & Ruutiainen, 2020). The majority, roughly 2/3rd of the total expense, fell into the categories of direct nonmedical costs and productivity loss, driven mainly by the early retirement of patients with secondary progressive disease (Purmonen et al, 2020). Up to date, comparable epidemiological data are needed according to the novel phenotypic classification system in order to assess the therapeutic, medical, and financial needs of patients with MS on a population basis (Kingwell et al, 2013), since many of the patients previously categorized with an R‐R disease now fall into the secondary progressive disease category according to the new classification system and therefore require a fundamentally different therapeutic approach, than before.…”

Prioritizing progressive MS rehabilitation research: A call from the International Progressive MS Alliance

“…The dysfunction that results from progressive MS is worse than RRMS with far reaching implications including loss of jobs, stress to family, and financial strain. 5,6 As in the research examining DMTs, the weight of evidence pertaining to symptom management comes overwhelmingly from studies predominantly or solely involving people with RRMS. 7 Collecting more data on progressive MS cohorts will allow for a more accurate and nuanced picture of progressive MS symptoms.…”

New epidemiological data of multiple sclerosis, the impact of psychopathological symptoms on the health-related quality of life of multiple sclerosis patients

“…Recent data has shed light on the fact that the socio-economical and financial burden an MS patient places on the healthcare provider and society is greatly dependent not just on the amount of the patients, but on the patient's disease type as well. Secondary progressive MS patients were shown to impose almost twice the burden on society than RRMS patients do [26]. Interestingly the bulk of the cost did not come from medical expenses but from the direct non-medical costs and productivity loss, which are the direct consequence of the early retirement of patients with SPMS [26].…”

“…Secondary progressive MS patients were shown to impose almost twice the burden on society than RRMS patients do [26]. Interestingly the bulk of the cost did not come from medical expenses but from the direct non-medical costs and productivity loss, which are the direct consequence of the early retirement of patients with SPMS [26]. I.…”