Economic Burden of the Out-of-Pocket Expenses for People with Multiple Sclerosis in France

Abstract

Background People with chronic diseases in France frequently incur out-of-pocket expenses (OOPE) related to their medical care. Objective The objective of this study was to evaluate OOPE incurred by people with multiple sclerosis (MS) with respect to direct non-medical and medical expenditure. Methods Data were collected through a web-based survey using an online patient community platform (Carenity). The survey questionnaire contained 87 questions (numerical response or Likert scale) and took less than 30 min to complete. Participants rated their disability on a ten-point scale. Results In total, 376 patients, with a mean age of 48.3 years (95% confidence interval [CI] 47.2-49.5), participated in the survey. Participants estimated that they spent an average of €127 each month on OOPE for their MS, principally on physician consultations (mean annual expenditure of €75 by 183 participants), non-physician consultations (€358 by 135 participants) and non-prescription medication (mean expense of €67 per pharmacy visit by 234 patients). In total, 77% of participants who needed adaptations to their home or vehicle because of their MS contributed to the cost. No obvious relationship between OOPE and self-rated disability was observed. A total of 61.4% of participants reported that they had to choose between spending money on MS care or on their family and social life. Conclusions Most patients with MS incurred significant OOPE linked to consultations, non-prescription medications or home equipment and medical equipment. These outlays could lead to dilemmas when choosing between spending on MS care or family or social life.

The socioeconomic impact of multiple sclerosis in France: Results from the PETALS study

“…The estimated OOPE is substantial given that French MS patients receive full healthcare coverage (ALD). Although the total annual OOPE incurred per MS patient was lower in the present study than in the Heinzlef et al study (€1500 vs €893.4), 29 it highlights that OOPEs are still daunting and that MS patients in France continue to incur high OOPEs for healthcare services/items not covered by health insurance.…”

Spatial and temporal distribution of the prevalence of unemployment and early retirement in people with multiple sclerosis: A systematic review with meta-analysis

“…The studies that described the early retirement prevalence were performed in 25 countries: The United States of America (19, 28.3%) [ 14 , 31 , 36 , 37 , 129 – 132 , 136 , 140 , 143 – 146 , 150 , 151 , 160 , 167 , 168 ] Germany (five, 7.5%) [ 97 , 99 , 100 , 102 , 103 ] United Kingdom (five, 7.5%) [ 29 , 32 , 120 , 122 , 123 ], Denmark (four, 6.0%) [ 73 – 76 ], Australia (three, 4.5%) [ 108 , 109 , 175 ], Belgium (three, 4.5%) [ 35 , 79 , 80 ], Holland (three, 4.5%) [ 61 , 63 , 176 ], Italy (three, 4.5%) [ 111 – 113 ], Ireland (two, 3.0%) [ 47 , 48 ], Spain (two, 3.0%) [ 8 , 28 ], Sweden (two, 3.0%) [ 90 , 91 ], Switzerland (two, 3.0%) [ 66 , 67 ], Argentina (one, 1.5%) [ 46 ], Austria (one, 1.5%) [ 39 ], Brazil (one, 1.5%) [ 55 ], the Czech Republic (one, 1.5%) [ 40 ], France (one, 1.5%) [ 85 ], Greece (one, 1.5%...…”

Economic burden of highly active relapsing-remitting multiple sclerosis patients in the French national health insurance database

“…In addition, our study disregards the cost of informal care (which is high in MS [31]), productivity loss, and out-of-pocket drugs costs (which exists despite MS is fully covered by NHI [18]).…”

“…Most of healthcare expenditures for long-term diseases' management (LTD), such as MS, are 100% reimbursed by the NHI [17]. Most of the remaining medical fees (out-of-pocket expenses) [18] are covered by an optional private health insurance or eligible for state funded free complementary health care [CMUc (Couverture Médicale Universelle complémentaire)] (provided that annual income is below 50% of the poverty threshold) [19].…”