Sunday, 17 July 2016

Cost of MS

Ernstsson O, Gyllensten H, Alexanderson K, Tinghög P, Friberg E, Norlund A. Cost of Illness of Multiple Sclerosis - A Systematic Review. PLoS One. 2016; 11(7):e0159129.

BACKGROUND: Cost-of-illness (COI) studies of Multiple Sclerosis (MS) are vital components for describing the economic burden of MS, and are frequently used in model studies of interventions of MS. We conducted a systematic review of studies estimating the COI of MS, to compare costs between studies and examine cost drivers, emphasizing generalizability and methodological choices.
MATERIAL AND METHOD: A literature search on studies published in English on COI of MS was performed in PubMed for the period January 1969 to January 2014, resulting in 1,326 publications. A mapping of studies using a bottom-up approach or top-down approach, respectively, was conducted for the 48 studies assessed as relevant. In a second analysis, the cost estimates were compared between the 29 studies that used a societal perspective on costs, human capital approach for indirect costs, presenting number of patients included, time-period studied, and year of price level used.
RESULTS: The mapping showed that bottom-up studies and prevalence approaches were most common. The cost ratios between different severity levels within studies were relatively stable, to the ratio of 1 to 2 to 3 for disability level categories. Drugs were the main cost drivers for MS-patients with low disease severity, representing 29% to 82% of all costs in this patient group, while the main cost components for groups with more advanced MS symptoms were production losses due to MS and informal care, together representing 17% to 67% of costs in those groups.
CONCLUSION: The bottom-up method and prevalence approach dominated in studies of COI of MS. Our findings show that there are difficulties in comparing absolute costs across studies, nevertheless, the relative costs expressed as cost ratios, comparing different severity levels, showed higher resemblance. Costs of drugs were main cost drivers for less severe MS and informal care and production losses for the most severe MS.

Have a read its open access


  1. The cost of MS needs to include the value of keeping pwMS in full time work. So if the drugs work it will be off set by the contributions made to the treasury. Working provides self esteem, financial rewards and stability in later life. The inability of so called disability advisors in the Local Job centres to truly understand the people they are meant to be helping is depressing. They are just a token gesture of successive Governments trying to reduce the Welfare bill not supporting the sick to genuinely find suitable jobs for the disabled. So when talking about the cost of MS, the whole picture needs to be assessed not just treatments in isolation.

  2. Volunteering is great for combatting isolation, feeling part of something, learning new skills and some organisations ask for a minimum of 2hrs a week for 6 months. I'm not well enough to work in a paid job currently but I do feel better psychologically since I've been volunteering.


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