Economic burden of multiple sclerosis: a systematic review of the literature.
Multiple sclerosis (MS) is a disease of the CNS, typically striking adults during the primary productive time of their life. The symptoms of MS can restrict the individual's physical activity and income-earning ability, resulting in a major financial burden on the patient, family, health system and society. This systematic literature review was conducted to document the economic burden of MS. Employing pre-defined search terms and inclusion/exclusion criteria, systematic searches were conducted in MEDLINE, EMBASE, PsycINFO, the Health Economic Evaluations Database (HEED), the NHS Economic Evaluation Database (EED) and the UK National Institute for Health and Clinical Excellence (NICE) website as well as conference abstracts. We identified 29 cost-of-illness studies that met the a priori inclusion criteria. The cost categories responsible for the majority of costs associated with MS varied across countries. There was a significant increase in costs associated with an increase in disease severity as measured by the Kurtzke Expanded Disability Status Scale (EDSS) score. The increase in magnitude was coupled with changes in the distribution of costs; although direct medical costs were important contributors in earlier stages of disease, they were outweighed by indirect costs in later stages, mainly due to relapses and productivity losses. Considering the increased costs associated with relapse occurrence and increasing disease severity, pharmaceutical or non-pharmaceutical interventions aimed at delaying the progression of disease may help to reduce the economic burden of MS.
Naci
Huseyin
H
Center for Health Economics & Science Policy, United BioSource Corporation, London, UK.
Fleurence
Rachael
R
Birt
Julie
J
Duhig
Amy
A
D017281:Cost of Illness; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D012008:Recurrence
Disabil Rehabil. 2001 Aug 15;23(12):516-21
11432648
Clin Drug Investig. 2004;24(7):409-20
17516727
Eur J Health Econ. 2006 Sep;7 Suppl 2:S45-54
17310336
Eur J Health Econ. 2006 Sep;7 Suppl 2:S86-95
17310338
Eur J Health Econ. 2006 Sep;7 Suppl 2:S96-104
17310341
Neurology. 1998 Jun;50(6):1594-600
9633699
J Manag Care Pharm. 2007 Jan-Feb;13(1):44-52
17269836
Value Health. 2007 Jan-Feb;10(1):54-60
17261116
Pharmacoeconomics. 1998 May;13(5 Pt 2):607-22
17165327
Eur J Health Econ. 2006 Sep;7 Suppl 2:S24-33
17318662
Acta Neurol Scand. 1997 May;95(5):268-74
9188900
Inj Prev. 2000 Sep;6(3):177-9
11003181
Mult Scler. 2008 Sep;14(8):1091-8
18728060
Eur J Health Econ. 2006 Sep;7 Suppl 2:S14-23
17310339
J Neurol. 2002 Feb;249(2):152-63
11985380
Eur J Health Econ. 2006 Sep;7 Suppl 2:S65-74
17310340
J Clin Neurosci. 2007 Jun;14(6):532-9
17430777
Acta Neurol Scand. 2002 Nov;106(5):241-7
12371915
Can J Neurol Sci. 1998 Feb;25(1):31-8
9532278
Pharmacoeconomics. 1998 May;13(5 Pt 2):597-606
17165326
J Neurol Sci. 2007 May 15;256 Suppl 1:S5-13
17346747
Int J Behav Med. 2007;14(1):3-11
17511528
BMJ. 2000 May 13;320(7245):1335
10807635
Pharmacoeconomics. 2001;19(2):207-13
11284384
Disabil Rehabil. 2003 Apr 22;25(8):369-79
12745946
Mult Scler. 1998 Oct;4(5):419-25
9839302
Eur J Neurol. 2001 Jan;8(1):27-35
11509078
Can J Neurol Sci. 2007 May;34(2):167-74
17598593
BMC Health Serv Res. 2003 Sep 02;3(1):17
12952552
Can J Neurol Sci. 1998 Feb;25(1):23-30
9532277
Clin Neurol Neurosurg. 2002 Jul;104(3):272-5
12127667
Mult Scler. 2007 Jul;13(6):800-4
17613609
Pharmacoeconomics. 2008;26(10):847-60
18793032
Pharmacol Rep. 2008 Sep-Oct;60(5):632-44
19066409
Eur J Health Econ. 2006 Sep;7 Suppl 2:S75-85
17310342
Neurology. 2002 Jan 8;58(1):37-43
11781403
J Am Geriatr Soc. 2000 Jun;48(6):639-46
10855599
Pharmacoeconomics. 1992 Jul;2(1):1-4
10146974
J Health Psychol. 2005 Jan;10(1):163-73
15576507
Neurology. 1997 Jan;48(1):74-80
9008497
Pharmacoeconomics. 2006;24(9):869-90
16942122
J Neurol Neurosurg Psychiatry. 1998 Apr;64(4):444-50
9576533
Mult Scler. 2007 Sep;13(8):1054-64
17623729
Mult Scler. 2008 Nov;14(9):1269-79
18653735
Value Health. 2007 Sep-Oct;10(5):386-9
17888103
Eur J Health Econ. 2006 Sep;7 Suppl 2:S5-13
17310344
BMC Health Serv Res. 2006 Nov 01;6:143
17078879
Eur J Health Econ. 2006 Sep;7 Suppl 2:S55-64
17310343
Work. 2007;29(4):303-11
18057570
Mult Scler. 2000 Apr;6(2):91-8
10773854
J Neurol Neurosurg Psychiatry. 2006 Aug;77(8):918-26
16690691