Healthcare Costs for Treating Relapsing Multiple Sclerosis and the Risk of Progression: A Retrospective Italian Cohort Study from 2001 to 2015

Abstract

BackgroundDisease modifying treatments (DMTs) are the main responsible for direct medical costs in multiple sclerosis (MS). The current investigation aims at evaluating possible associations between healthcare costs for treating relapsing remitting MS (RRMS) and disease evolution.MethodsThe present cohort study retrospectively included 544 newly diagnosed RRMS patients, prospectively followed up for 10.1±3.3 years. Costs for DMT administration and management were calculated for each year of observation. Following clinical endpoints were recorded: time to first relapse, 1-point EDSS progression, reaching of EDSS 4.0, reaching of EDSS 6.0, and conversion to secondary progressive MS (SP). Covariates for statistical analyses were age, gender, disease duration and EDSS at diagnosis.ResultsAt time varying Cox regression models, 10% increase in annual healthcare costs was associated with 1.1% reduction in 1-point EDSS progression (HR = 0.897; p = 0.018), with 0.7% reduction in reaching EDSS 6.0 (HR = 0.925; p = 0.030), and with 1.0% reduction in SP conversion (HR = 0.902; p = 0.006).ConclusionHigher healthcare costs for treating MS have been associated with a milder disease evolution after 10 years, with possible reduction of long-term non-medical direct and indirect costs.

Autologous haematopoietic stem cell transplantation and other cellular therapy in multiple sclerosis and immune-mediated neurological diseases: updated guidelines and recommendations from the EBMT Autoimmune Diseases Working Party (ADWP) and the Joint Accreditation Committee of EBMT and ISCT (JACIE)

“…Following diagnosis, patients rapidly fall out of employment, with recent data indicating that after 5 years only 25% of people are still working. As a result, MS has an economic impact disproportionate to its prevalence related to the high cost of disease modifying therapies (DMTs), the direct and indirect costs of relapses and associated costs of benefits and personal care [3].…”

Burden of Relapsing-Remitting Multiple Sclerosis on Workers in the US: A Cross-sectional Analysis of Survey Data

“…Healthcare costs in MS are driven by the use of disease modifying treatments (DMTs), which are prescribed based on the initial severity of MS and on its subsequent progression. 50 Moccia et al 50 found that patients who received more expensive DMTs, specifically indicated for a more aggressive disease progression, presented better long-term outcomes (such as lower risk of reaching milestones of short-and long-term disease progression) compared with patients with relatively milder symptoms who received lower-cost DMTs. This issue should be considered not only by physicians when assessing patients with MS to design the most suitable course of treatment, but also by policy makers when establishing eligibility criteria for DMTs.…”

“…This issue should be considered not only by physicians when assessing patients with MS to design the most suitable course of treatment, but also by policy makers when establishing eligibility criteria for DMTs. 50,51 These more expensive DMTs could have beneficial effects on the MS patients' ability to work, which could be evaluated in further studies.…”

Environmental factors and a risk for multiple sclerosis in the Altai Territory

“…Установлено, что весомый вклад в развитие этого мультифакторного заболевания вносят генетическая предрасположенность и экологические причины [5,6]. Увеличение распространенности РС в последние годы, рост прямых и косвенных затрат на его лечение определяют необходимость поиска путей первичной профилактики и новых подходов к терапии этого заболевания [7,8].…”

“…населения -Целинный (75,4), Мамонтовский (74,3), Новичихинский (60,9), Славгородский (60,7), и районы, в которых этот показатель менее 10 на 100 тыс. населения -Немецкий национальный район (9,8), Быстроистокский (8,1), Чарышский (7,4), Крутихинский (7,2), Бурлинский (6,7), Егорьевский (6,3), Советский (5,6), Хабарский (5,2).…”