title: Economic costs associated with an MS relapse.
abstract: BACKGROUND
  Multiple sclerosis (MS) commonly affects young adults and can be associated with significant disability resulting in considerable socioeconomic burden for both patient and society.
  
  
  OBJECTIVE
  The aim was to determine the direct and indirect cost of an MS relapse.
  
  
  METHODS
  This was a prospective audit composed of medical chart review and patient questionnaire. Relapses were stratified into 3 groups: low, moderate and high intensity. Age, gender, MS subtype, disease duration, expanded disability status scale (EDSS) score, disease modifying therapy (DMT) use and employment status were recorded. Direct costs included GP visits, investigations, clinic visit, consultations with medical staff, medication and admission costs. Indirect costs assessed loss of earnings, partner׳s loss of earnings, childcare, meals and travel costs.
  
  
  RESULTS
  Fifty-three patients had a clinically confirmed relapse. Thirteen were of low intensity; 23 moderate intensity and 17 high intensity with mean costs of €503, €1395 and €8862, respectively. Those with high intensity episodes tended to be older with higher baseline EDSS (p<0.003) and change in EDSS (p<0.002). Direct costs were consistent in both low and moderate intensity groups but varied with length of hospital stay in the high intensity group. Loss of earnings was the biggest contributor to indirect costs. A decision to change therapy as a result of the relapse was made in 23% of cases, further adding to annual MS related costs.
  
  
  CONCLUSIONS
  The cost of an MS relapse is dependent on severity of the episode but even low intensity episodes can have a significant financial impact for the patient in terms of loss of earnings and for society with higher annual MS related costs.
authors.affiliation: Department of Neurology, St Vincent׳s University Hospital, Elm Park, Dublin 4, Ireland. Electronic address: k.oconnell@svuh.ie.
authors.forename: K
authors.initials: K
authors.lastname: O'Connell
authors.affiliation: Department of Neurology, St Vincent׳s University Hospital, Elm Park, Dublin 4, Ireland.
authors.forename: S B
authors.initials: SB
authors.lastname: Kelly
authors.affiliation: Department of Neurology, St Vincent׳s University Hospital, Elm Park, Dublin 4, Ireland.
authors.forename: E
authors.initials: E
authors.lastname: Fogarty
authors.affiliation: Department of Neurology, St Vincent׳s University Hospital, Elm Park, Dublin 4, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Duggan
authors.affiliation: Department of Neurology, St Vincent׳s University Hospital, Elm Park, Dublin 4, Ireland.
authors.forename: L
authors.initials: L
authors.lastname: Buckley
authors.affiliation: Department of Neurology, St Vincent׳s University Hospital, Elm Park, Dublin 4, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Hutchinson
authors.affiliation: Department of Neurology, St Vincent׳s University Hospital, Elm Park, Dublin 4, Ireland.
authors.forename: C
authors.initials: C
authors.lastname: McGuigan
authors.affiliation: Department of Neurology, St Vincent׳s University Hospital, Elm Park, Dublin 4, Ireland.
authors.forename: N
authors.initials: N
authors.lastname: Tubridy
mesh_terms: D000328:Adult; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000191:economics* / Q000453:epidemiology; D011446:Prospective Studies; D012008:Recurrence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Direct cost; Economic cost; Indirect cost; Multiple sclerosis; Relapse