title: [The cost of treatment of multiple sclerosis in Colombia].
abstract: OBJECTIVE
  To estimate, according to the states of disease (remission or relapse) and her level of progression (EDSS), the cost of treatment of Multiple Sclerosis (MS) in Colombia.
  
  
  METHODS
  From the perspective of the third payer, a cost study of MS was performed using two-way estimation techniques: a) "Top down" to estimate the costs during relapses from clinical registers of 304 patients; b) "bottom-up" to estimate the cost in remission from a questionnaire (Kobelt 2006) applied to 137 patients, located in different regions of Colombia.
  
  
  RESULTS
  The mean of patient's age was 43,7 years and 73% of those were women. The mean annual cost per patient varied according to the disease phase, finding the highest value in Phase II (EDSS 3 - 5,5) with $ 50.581.216 COP (US$ 25.713) and the lowest one in Phase IV (EDSS 8 - 9,5) with $20.738.845 COP (US$ 10.543). The cost of Disease Modifier Drugs (DMD) represented 91.5% from the medial total annual cost of 1,2 and 3 phases. The participation of DMD was 58%.in the 4 phase. Indirect costs are minimal participation in all phases, except for 4 where increases at the expense of reduced consumption of DMD. Costs associated with the period of relapses of MS are low against the total cost, with an average cost of $ 2,433,182 COP ($ 1.237 USD).
  
  
  CONCLUSIONS
  MS in Colombia is a disease with a behavioral pathology "high cost " to the social security system (SGSSS), generated mainly at the expense of their direct costs, which, even without including relapses, an aggregate amount of more than 75 times the annual premium cost of health insurance for Colombia ($ 430,488 COP) in the year under review (2008).
authors.affiliation: Fundación Salutia Centro de investigaciones económicas, de gestión y tecnologías en salud, Bogotá, Colombia. martin.romero@salutia.org
authors.forename: Martin
authors.initials: M
authors.lastname: Romero
authors.forename: Carlos
authors.initials: C
authors.lastname: Arango
authors.forename: Nelson
authors.initials: N
authors.lastname: Alvis
authors.forename: Juan Camilo
authors.initials: JC
authors.lastname: Suarez
authors.forename: Aristides
authors.initials: A
authors.lastname: Duque
mesh_terms: D000328:Adult; D003105:Colombia; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007155:Immunologic Factors / Q000191:economics / Q000627:therapeutic use; D007349:Insurance, Health, Reimbursement / Q000191:economics; D008297:Male; D018803:Models, Economic; D009103:Multiple Sclerosis / Q000191:economics* / Q000628:therapy; D009313:National Health Programs / Q000191:economics; D010043:Outcome and Process Assessment, Health Care / Q000191:economics*; D012008:Recurrence; D012042:Registries; D012943:Social Security / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007155:Immunologic Factors