title: Social participation in patients with multiple sclerosis: correlations between disability and economic burden.
abstract: BACKGROUND
  Economic costs related to treatment of multiple sclerosis (MS) must be justified by health state, quality of life (QOL) and social participation improvement. This study aims to describe correlations between social participation, economic costs, utility and MS-specific QOL in a sample of patients with MS (pwMS).
  
  
  METHODS
  We interviewed 42 pwMS receiving natalizumab and collected clinical data, direct medical costs, productivity loss, utility (EQ5D-VAS), MS-specific QOL (SEP-59), social participation with the Impact on Participation and Autonomy questionnaire (IPA). We performed descriptive and correlation analyses.
  
  
  RESULTS
  41 pwMS, with a mean Expanded Disability Status Scale (EDSS) score of 4.0, completed questionnaires. Mean annual global cost per patient was 68448 +/-33374 Euros and increased with EDSS (r = 0.644), utility (r = -0.456) and IPA (r = 0.519-0.671) worsening. Mean utility was 0.52 +/- 0.28. Correlations between IPA and QOL (EQ5D-VAS or SEP-59) were observed (r = -0.53 to -0.78). Association between QOL and EDSS was smaller (EQ5D-VAS) or absent. Productivity losses were poorly correlated to EDSS (r = 0.375).
  
  
  CONCLUSIONS
  Moderate to strong correlations of social participation with clinical status (EDSS), QOL, utility and economic costs encourage exploring better these links in larger cohorts. The stronger correlation between social participation and QOL than between EDSS and QOL needs to be confirmed.
authors.affiliation: PRES Lille Nord de France, Lille, France. kwiatkowski.arnaud@ghicl.net.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Kwiatkowski
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Marissal
authors.forename: Madani
authors.initials: M
authors.lastname: Pouyfaucon
authors.forename: Patrick
authors.initials: P
authors.lastname: Vermersch
authors.forename: Patrick
authors.initials: P
authors.lastname: Hautecoeur
authors.forename: Benoît
authors.initials: B
authors.lastname: Dervaux
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D017281:Cost of Illness; D004185:Disability Evaluation; D004651:Employment; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000191:economics* / Q000503:physiopathology*; D000069442:Natalizumab; D026684:Personal Autonomy; D011788:Quality of Life; D012919:Social Behavior
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; D000069442:Natalizumab