Health outcomes in multiple sclerosis.
OBJECTIVE
Economic considerations are increasingly important in the evaluation of innovative medical technologies. In the past few years, evaluations of cost and cost-effectiveness analysis became a popular topic for multiple sclerosis research. Here, we review cost-of-illness and cost-utility studies in multiple sclerosis published during the past 2 years.


RESULTS
Despite differences in methodology, several cost-of-illness studies unequivocally demonstrated that indirect costs as a result of sick leave, premature retirement or loss of income made up almost half of the overall costs, and that total costs were higher in the more advanced stages of the disease. Cost-effectiveness studies of recombinant IFN-beta preparations demonstrated a marked variability in the incremental cost per quality-adjusted life-year, with amounts ranging from Euro 28 432 to US$338 738. For glatiramer acetate and mitoxantrone, only limited data are available, but even these few studies differed in their results.


CONCLUSIONS
Health outcome studies constitute a new and emerging field of multiple sclerosis research. All studies performed so far underscore the importance of indirect cost in multiple sclerosis. However, the marked differences in cost-effectiveness studies illustrate that the method of economic modeling has considerable impact on the results of these studies, which need standardization in order to evaluate properly the economic consequences of new and expensive therapies in multiple sclerosis.
Flachenecker
Peter
P
Department of Neurology and Clinical Research Group for Neuroimmunology, Julius Maximilians Universität Würzburg, Würzburg, Germany. peter.flachenecker@surfeu.de
Rieckmann
Peter
P
D003362:Cost-Benefit Analysis; D000068717:Glatiramer Acetate; D006801:Humans; D007155:Immunologic Factors / Q000191:economics* / Q000627:therapeutic use; D016899:Interferon-beta / Q000191:economics* / Q000627:therapeutic use; D008942:Mitoxantrone / Q000191:economics / Q000627:therapeutic use; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000191:economics; D017063:Outcome Assessment, Health Care / Q000191:economics*; D010455:Peptides / Q000191:economics / Q000627:therapeutic use; D011788:Quality of Life
D007155:Immunologic Factors; D010455:Peptides; D000068717:Glatiramer Acetate; D016899:Interferon-beta; D008942:Mitoxantrone