Impact on healthcare resource utilization of multiple sclerosis in Spain

Abstract

BackgroundMultiple sclerosis (MS) is a chronic disease with a high socioeconomic impact. The aim of this study was to assess healthcare resources utilization and costs in a sample of patients with MS.MethodsA retrospective, cohort study was conducted using electronic medical records from 19 primary care centres in Asturias and Catalonia, Spain. Adult patients diagnosed with MS were distributed into two groups according to the Expanded Disability Status Scale (EDSS) score: 0–3.5 (no-moderate disability) and 4–9.5 (severe disability). Healthcare (direct cost) and non-healthcare costs (work productivity losses) were analysed. An analysis of covariance (ANCOVA) was used for correction, p < 0.05. A multiple regression model was performed to obtain the variables associated with costs.ResultsA total of 222 patients were analyzed; mean (SD) age: 45.5 (12.5) years, 64.4% female, and 62.2% presented a diagnosis of relapsing-remitting MS. Median EDSS score was 2.5, with 68.5% of the patients with no to moderate disability. The mean annual cost per MS patient was €25,103. For no-moderate and severe disability, the ANCOVA-adjusted mean annual cost was €23,157 and €29,242, respectively (p = 0.013). Direct costs and MS disease-modifying therapy accounted for 39.4% and 31.7% of the total costs, respectively. The total costs were associated with number of relapses (β = 0.135, p = 0.001), time since diagnosis (β = 0.281, p = 0.023), and age (β = 0.198, p = 0.037).ConclusionsMultiple sclerosis imposes a substantial economic burden on the Spanish National Health System, patients and society as a whole. Costs significantly correlated with disease progression.

<p>Adherence to disease-modifying treatments in patients with multiple sclerosis in Spain</p>

“…In Spain, this cost was €23,157 and €29,242 in mild and severe cases, respectively, demonstrating elevated costs for the Spanish National Health System. Costs are significantly correlated with disease progression 9…”

SROI-EM. Impacto clínico, asistencial, económico y social del abordaje ideal de la Esclerosis Múltiple en comparación con el abordaje actual

“…La carga económica de la EM en España se ha estimado en varios estudios [41,42,[55][56][57] . Karampampa et al (2012) analizaron los costes de esta enfermedad desde la perspectiva social.…”

“…Sin embargo, en los pacientes con discapacidad grave, el coste directo sanitario es superior (24.344€) y los componentes principales son el TME (7.419€) y las hospitalizaciones (7.437€) [41] . Además, se estima que el coste directo sanitario de la EM está asociado al número de recaídas, al tiempo desde el diagnóstico y a la edad de los pacientes [55] .…”

“…• Se reducirían los costes totales al tratar a los pacientes con EMSP, actualmente sin tratar Si un tratamiento permite no progresar en discapacidad, es posible calcular la diferencia entre el coste de tratar a un paciente moderado frente a tratar a un paciente leve [55,75] .…”

“…Por otro lado, el coste asociado al manejo de los pacientes con EM es menor en presencia de una EDSS menor, por lo que la prevención de la discapacidad puede suponer tanto un ahorro de costes directos sanitarios, como de cuidados informales y pérdidas de productividad laboral [55,137] .…”