title: A study on the direct and indirect costs of multiple sclerosis based on expanded disability status scale score in khuzestan, iran.
abstract: BACKGROUND
  Multiple sclerosis is a common and chronic neurologic disorder. This disorder imposes physical, economic, and psychosocial burden on individuals, their families and society. This study aims to analyze the costs of multiple sclerosis disease based on the severity of disability.
  
  
  METHODS
  We performed a cross-sectional cost of illness study. This study was conducted in 332 patients of Khuzestan province of Iran. Data were included: Patient's characteristics, disability status, medical, and nonmedical costs and were gathered by using the questionnaire during 3 months period. Costs analysis was performed in the basis of expanded disability status scale (EDSS). Data were analyzed by using SPSS 18 software.
  
  
  RESULTS
  Mean age of the patients was 33.5 (standard deviation [SD]: 9.1) and 70.5% of patients were female. Mean EDSS score of the patients was 2.2 (SD: 1.6). Most patients (92.1%) had relapsing remitting multiple sclerosis (MS) form of the disease. Costs mean per patients was 8.6 ± 7.9 million Rial. The direct and indirect costs were 93.1% and 6.9% of total costs, respectively. The major cost of the disease belongs to the pharmaceutical treatment (22% of costs). The majority costs (approximately 62%) attributed to EDSS of 6-7 and >7. Furthermore, there was strong significant relationship between cost of illness and disability severity of patients (P < 0.05).
  
  
  CONCLUSIONS
  Cost mean per MS patients was relatively high. Furthermore, the results showed that cost of disease had positive and significant relationships with EDSS score that is, progression of disability increase costs of patients.
authors.affiliation: Department of Health Economic and Management, School of Public Health, Tehran University of Medical Sciences Tehran, Iran.
authors.forename: Amin
authors.initials: A
authors.lastname: Torabipour
authors.affiliation: Department of Rehabilitation Administration, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Zahra Ahmadi
authors.initials: ZA
authors.lastname: Asl
authors.affiliation: Department of Neurology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Nastaran
authors.initials: N
authors.lastname: Majdinasab
authors.affiliation: Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Ghasemzadeh
authors.affiliation: Department of Epidemiology and Biostatistics, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Hamed
authors.initials: H
authors.lastname: Tabesh
authors.affiliation: Department of Health Economic and Management, School of Public Health, Tehran University of Medical Sciences Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Arab
keywords: Direct cost; expanded disability status; indirect cost; multiple sclerosis