Costs and Quality of Life in Multiple Sclerosis A Cross-Sectional Study in the USA

Abstract

Treatment of multiple sclerosis (MS) has changed substantially during the past decade, as new biological disease-modifying treatments have been introduced in a field where only symptomatic pharmacological treatment had been available.The new treatments come at a high cost, between $ 8-12,000 per patient and year.Consequently, it must be expected that the part of total costs represented by drugs has increased, from essentially a very minor part in the nineties (2-5%) to a much larger proportion.However, no studies investigating this development from a societal perspective have so far been published. ObjectiveThe objective of this study was to investigate the current cost structure in MS and the effect of disease severity on costs and quality of life (utility) for patients treated with the new disease modifying drugs (DMDs) in the US. MethodsThe study follows closely the methodology used in three previous observational studies in Sweden, the United Kingdom and Germany.It is a descriptive bottom-up prevalencebased cost of illness study.The analysis was performed from the societal perspective and did not investigate costs for different payers.Costs were calculated as mean annual cost per patient in the sample, and mean costs for patients using a given resource.All unit costs are for 2004, or were inflated to 2004 using the CPI.Demographic variables, information on disease severity and disease activity, resource utilization and utility were collected directly from a sub-sample of ~24,000 patients taking part in a regular follow-up since up to 8 years, the North American Committee on Multiple Sclerosis (NARCOMS) Patient Registry.A questionnaire was mailed to a 4,000 randomly selected sample and the target answer rate was 50%.