Estimate of the cost of multiple sclerosis in Spain by literature review

Fernández, Óscar; Calleja‐Hernández, Miguel Ángel; Meca-Lallana, José; Oreja‐Guevara, Celia; Polanco, Ana; Pérez-Alcántara, F.

doi:10.1080/14737167.2017.1358617

Cited by 23 publications

(28 citation statements)

References 52 publications

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“…Fatigue and cognitive complaints were found in 92 and 64% of participants, respectively. Fatigue and cognitive disturbances are much more common than mobility problems in people who are working [8, 19]. MS-related productivity loss due to presenteeism was three times that of absenteeism in a study with 740 MS employees conducted in Australia [4].…”

Section: Discussionmentioning

confidence: 99%

“…In some European countries, MS caregivers provide 150 h a month of care to pwMS, the equivalent of full-time employment [1]. The mean annual cost per patient in Spain was €30,050 [8]. Sicras et al found that only 30% of MS people were employed or self-employed [9].…”

Section: Introductionmentioning

confidence: 99%

“…More than 30% of pwMS had an early retirement, in most cases due to disability. Indirect costs in Spain accounted for between 24 and 35% of disease costs, increasing as disability advanced, and reaching over €15,779 in subjects essentially restricted to a wheelchair [8]. However, available data related to the economic burden of MS, especially limitations in work activities and job performance remains limited.…”

Section: Introductionmentioning

confidence: 99%

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Economic burden of multiple sclerosis in a population with low physical disability

et al. 2019

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Background In multiple sclerosis (MS), half of affected people are unemployed within 10 years of diagnosis. The aim of this study was to assess the economic impact of MS in adult subjects with relapsing-remitting MS (RRMS) and primary progressive MS (PPMS). Methods A multicenter, non-interventional, cross-sectional study was conducted. The Expanded Disability Status Scale (EDSS) and the 23-item Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ-23) were used to assess disability and work performance, respectively. Only indirect costs were considered using the human capital method, including work costs. Professional support costs and informal caregivers’ costs were also estimated. Results A total of 199 subjects were studied (mean age: 43.9 ± 10.5 years, 60.8% female, 86.4% with RRMS). Median EDSS score was 2.0 (interquartile range: 1.0–3.5) and median MSWDQ-23 total score was 31.5 (15.2, 50.0). The number of employed subjects decreased after MS diagnosis from 70.6 to 47.2%, and the number of retired people increased (23.6%). Mean age of retirement was 43.6 ± 10.5 years. Ten percent of the population had sick leaves (absenteeism was seen in 90.9% of the student population and 30.9% of the employed population). Professional support in their daily life activities was needed in 28.1% of subjects. Costs for sick leave, work absenteeism, premature retirement and premature work disability/pensioner were €416.6 ± 2030.2, €763.4 ± 3161.8, €5810.1 ± 13,159.0 and €1816.8 ± 9630.7, respectively. Costs for professional support and informal caregiving activities were €1026.93 ± 4622.0 and €1328.72, respectively. Conclusions MS is responsible for a substantial economic burden due to indirect and informal care costs, even in a population with low physical disability.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Economic burden of multiple sclerosis in a population with low physical disability

et al. 2019

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“…According to a cross-sectional Spanish study [6], 92% and 64% of patients with MS analyzed experienced fatigue and cognitive problems, respectively, with a mean utility (quality of life as perceived by the patient) of 0.772 and costs per patient per year (from the societal perspective) ranging between 20,600 € with a score in the Expanded Disability Status Scale (EDSS) of 0 to 3 and 68,700 € with an EDSS score of 7 to 9. In Spain, the total annual cost of MS has been estimated at 1,4 billion euros (40% direct healthcare cost, 30% direct non-healthcare cost and 30% indirect cost) [7].…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of Cladribine Tablets and fingolimod in the treatment of relapsing multiple sclerosis with high disease activity in Spain

Poveda

Trillo

Rubio-Terrés

et al. 2019

Expert Review of Pharmacoeconomics & Outcomes Research

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Objective: To estimate the cost-effectiveness of Cladribine Tablets in the treatment of relapsing multiple sclerosis (RMS) with high disease activity compared with fingolimod, from the perspective of the National Health System (NHS) in Spain. Methods: A Markov model was developed. The annual transition probabilities, were adjusted to patients with RMS with high disease activity. The effect of the treatments compared on the Expanded Disability Status Scale (EDSS) was modeled by hazard ratios for the confirmed progression of disability. The annual relapse rate and the probability of suffering adverse reactions were obtained from a meta-analysis and the literature. The derived costs were calculated from Spanish unit costs. The utilities were obtained from the CLARITY clinical trial and the literature. Deterministic and probabilistic sensitivity analyzes were performed. Results: Cladribine tablets was the dominant treatment: lower costs (−86,536 €) and more effective (+1.11 quality-adjusted life years-QALYs) compared to fingolimod. The probability that Cladribine Tablets was costeffective compared to fingolimod ranged between 94.6% and 96.1% for willingness to pay from € 20,000 to € 30,000 per QALY gained. Conclusions: Cladribine Tablets is a cost-effective treatment, compared to fingolimod, for the treatment of RMS with high disease activity. Expert Opinion: According to the present study, compared to fingolimod, treatment with Cladribine Tablets of relapsing multiple sclerosis with high disease activity is an option that could generate savings for the Spanish National Health System, with a considerable gain in QALYs. Cladribine Tablets is considered cost-effective and dominant (less costs and more effectiveness) than fingolimod treatment option in this population.

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“…Mental and neurological disorders also have a substantial economic impact in Spain (equivalent to almost 8% of the country’s GDP) with a mean yearly per-patient cost of €30,050 for MS patients [ 14 , 15 ]. However, information about the use of healthcare resources and associated costs among patients with MS in Spain is limited.…”

Section: Introductionmentioning

confidence: 99%

Impact on healthcare resource utilization of multiple sclerosis in Spain

Sicras‐Mainar¹,

Ruíz-Beato

Navarro‐Artieda

et al. 2017

BMC Health Serv Res

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BackgroundMultiple sclerosis (MS) is a chronic disease with a high socioeconomic impact. The aim of this study was to assess healthcare resources utilization and costs in a sample of patients with MS.MethodsA retrospective, cohort study was conducted using electronic medical records from 19 primary care centres in Asturias and Catalonia, Spain. Adult patients diagnosed with MS were distributed into two groups according to the Expanded Disability Status Scale (EDSS) score: 0–3.5 (no-moderate disability) and 4–9.5 (severe disability). Healthcare (direct cost) and non-healthcare costs (work productivity losses) were analysed. An analysis of covariance (ANCOVA) was used for correction, p < 0.05. A multiple regression model was performed to obtain the variables associated with costs.ResultsA total of 222 patients were analyzed; mean (SD) age: 45.5 (12.5) years, 64.4% female, and 62.2% presented a diagnosis of relapsing-remitting MS. Median EDSS score was 2.5, with 68.5% of the patients with no to moderate disability. The mean annual cost per MS patient was €25,103. For no-moderate and severe disability, the ANCOVA-adjusted mean annual cost was €23,157 and €29,242, respectively (p = 0.013). Direct costs and MS disease-modifying therapy accounted for 39.4% and 31.7% of the total costs, respectively. The total costs were associated with number of relapses (β = 0.135, p = 0.001), time since diagnosis (β = 0.281, p = 0.023), and age (β = 0.198, p = 0.037).ConclusionsMultiple sclerosis imposes a substantial economic burden on the Spanish National Health System, patients and society as a whole. Costs significantly correlated with disease progression.

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Estimate of the cost of multiple sclerosis in Spain by literature review

Cited by 23 publications

References 52 publications

Economic burden of multiple sclerosis in a population with low physical disability

Economic burden of multiple sclerosis in a population with low physical disability

Cost-effectiveness of Cladribine Tablets and fingolimod in the treatment of relapsing multiple sclerosis with high disease activity in Spain

Impact on healthcare resource utilization of multiple sclerosis in Spain

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