title: Treatment experience, burden and unmet needs (TRIBUNE) in MS study: results from five European countries.
abstract: BACKGROUND
  Multiple sclerosis (MS) is a common cause of neurological disability in young adults. The TRIBUNE study provides a detailed exploration of costs in relation to relapses and disease severity, and assesses the quality of life impact on MS patients in terms of utilities, fatigue and activities of daily living (ADL).
  
  
  METHODS
  Patients in five European countries (France, Germany, Italy, Spain and the United Kingdom) completed a self-administered web-based questionnaire capturing information on demographics, disease characteristics and severity (EDSS), co-morbidities, relapses, resource consumption, utilities, fatigue, and activities of daily living.
  
  
  RESULTS
  In total, 1261 MS patients completed the questionnaire. More than half of the patients (68%) had the relapsing-remitting form of the disease; 87% of the sample reported receiving MS treatments. Costs were higher with advancing disease severity; for mild patients (EDSS score ≤ 3) the costs ranged between €13,534 and €22,461 across countries; for moderate (EDSS score 4 - 6.5) between €28,524 and €43,948; for severe (EDSS ≥ 7) between €39,592 and €65,395. Relapses were also associated with increasing costs; the difference in the cost per patient per year for relapsing-remitting patients with EDSS score ≤ 5 that did experience at least one relapse during the past 12 months and those who did not ranged between €3321 and €9430. The quality of life of patients decreased with disease progression and existence of relapses.
  
  
  CONCLUSIONS
  The TRIBUNE study provides an important update on the economic burden of MS in an era of more widespread use of disease-modifying therapies. It explores the cost of MS linked to relapses and disease severity, and examines the impact of MS on additional health outcomes beyond utilities such as ADL and fatigue.
authors.affiliation: OptumInsight, Stockholm, Sweden. korinna.karampampa@ki.se
authors.forename: Korinna
authors.initials: K
authors.lastname: Karampampa
authors.forename: Anders
authors.initials: A
authors.lastname: Gustavsson
authors.forename: Carolin
authors.initials: C
authors.lastname: Miltenburger
authors.forename: Benjamin
authors.initials: B
authors.lastname: Eckert
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D017281:Cost of Illness; D005060:Europe; D005221:Fatigue / Q000191:economics / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications* / Q000191:economics*; D011788:Quality of Life; D012008:Recurrence; D011795:Surveys and Questionnaires