title: Multiple sclerosis: relapses, resource use, and costs.
abstract: BACKGROUND
  Relapses can have a major impact on the lives of people with multiple sclerosis (MS), and yet relapse-related healthcare costs have received little attention. This has limited cost-effectiveness analyses of treatments for MS and hampered decision-making regarding the funding of MS healthcare services.
  
  
  OBJECTIVE
  To describe health/social care resource use and costs according to the frequency, severity, and endurance of MS relapses.
  
  
  METHODS
  Data from the prospective, longitudinal UK South West Impact of Multiple Sclerosis cohort were used. A total of 11,800 questionnaires from 1441 people with MS were available, including data on relapses, contacts with health/social care professionals, and other MS-related resource use.
  
  
  RESULTS
  The mean (SD) 6-monthly MS-related health/social care cost for individuals who reported a relapse was £519 (£949), compared to £229 (£366) for those who had not did report a relapse. Care costs varied widely dependent on the characteristics of the relapse. The mean (SD) cost when a relapse was not treated with steroids was £381 (£780), whilst the equivalent cost was £3579 (£1727) when a relapse resulted in hospitalization.
  
  
  CONCLUSIONS
  The impact of relapses on health and social care resources and costs differs according to their frequency, length, and severity. The data provided here can be used in cost-effectiveness analyses and to inform decision-making regarding healthcare provision for people with this condition.
authors.affiliation: Health Economics Group, University of Exeter Medical School, University of Exeter, South Cloisters, St Luke's Campus, Magdalen Road, Exeter, Devon, EX1 2LU, UK. a.hawton@exeter.ac.uk.
authors.forename: A J
authors.initials: AJ
authors.lastname: Hawton
authors.affiliation: Health Economics Group, University of Exeter Medical School, University of Exeter, South Cloisters, St Luke's Campus, Magdalen Road, Exeter, Devon, EX1 2LU, UK.
authors.forename: C
authors.initials: C
authors.lastname: Green
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D017059:Models, Econometric; D009103:Multiple Sclerosis / Q000191:economics*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000191:economics; D011446:Prospective Studies; D012720:Severity of Illness Index; D012947:Social Work / Q000191:economics; D055815:Young Adult
keywords: Cost-effectiveness; Costs; Decision-making; Multiple sclerosis; Relapse; Resource use