Sept 2019While economic issues differ across countries and healthcare systems, a universal concern is that Multiple Sclerosis (MS) is a costly disease that exerts a significant burden on patients, families, and society as a whole.
Speaking at the ECTRIMS 2019 Congress in Stockholm, health economist Gisela Kobelt, PhD, MBA, described concepts associated with economic burden in MS.
burden for people with MS
is related to reduced quality of life through physical suffering, limitations imposed on daily life, loss of work, and anxiety about the future." Economic factors may include loss of income for the patient, care-giving time for the family, and societal costs, which include burden on the healthcare system due to high healthcare utilization.
Not surprisingly, the evidence shows that the burden of disease
increases with a patient's level of disability
. As the disease
progresses, quality of life declines sharply, she explained, but costs increase. "Our aim, therefore, is to try to change the slope of this curve and delay the time it takes for patients to become severely disabled."
Dr. Kobelt presented observational data from the European Burden of Illness Study, a cross-sectional study involving 16,808 people with MS
from 16 countries (mean age was 51.5 years, 52% had relapsing MS
). Participants reported on their disease
, its impact on health-related quality of life, and consumption of healthcare resources. The goal of the study, Dr. Kobelt said, was to assess whether MS
management approaches provide value to society. Some of the findings:
Work capacity declined from 82% to 8%;Utility declined dramatically from normal levels to less than zero with advancing disease
. (In health economics, utility is a quality of life measure in which 0 represents death and 1 represents perfect health);Fatigue was reported by 95% of participants and cognitive difficulties by 71%; both had a significant independent effect on utility;Costs increased by 6-fold for those with the highest level of disability
compared with the lowest level.
Previous work by Dr. Kobelt showed that the greatest effects of MS
on employment occur at relatively low levels of physical disability
. This underscores the report’s recommendation of aiming to alter the disease
course through lifestyle measures and early treatment with disease
-modifying therapy. "The time to intervene is obviously at the beginning," Dr. Kobelt stressed. "We are not gaining much if we start when disease
is advanced or the costs are already high. We really want to intervene early to achieve gains in quality of life and potential cost savings."