Brain health: time matters in multiple sclerosis stated that the “costs of multiple sclerosis soar as the disease progresses”. A major new European study looks in more detail at how costs, employment and quality of life are all affected by increasing disease severity in people with multiple sclerosis (MS).1
Over 16,000 people with MS in 16 European countries were asked about their disease, quality of life, employment status, use of healthcare services and use of formal and informal care services. The results show that as MS progresses and disability increases, costs increase while quality of life goes down.
Early in the disease, costs are predominantly driven by disease modifying therapies (DMTs), but when the disease becomes severe costs increase, with community services and informal care making up a large proportion. Overall the average cost per year of all resources relating to MS, adjusted to reflect prices of ordinary goods in each country, was:
€22,800 for those with mild disease severity
€37,100 for those with moderate disease severity
€57,500 for those with severe disease.
Production losses owing to unemployment contribute to these costs. Among those of working age, 18% of people with mild disease were unemployed, but this figure was 92% among people with severe disease. Fatigue and cognitive difficulties were the main reasons that people gave for reduced work productivity. In a blog post about the results, the lead author Dr Gisela Kobelt commented, “I find the effect of MS on work capacity quite dramatic and an area where we could certainly improve support to patients.”2
As expected, disability was a strong driver of reduced health-related quality of life. Of note, fatigue (experienced by 95% of those surveyed) and cognitive difficulties (experienced by 71% of those surveyed) also independently reduced health-related quality of life.
In conclusion, costs, employment status and quality of life were closely linked to disease severity across Europe, therefore slowing or preventing disease progression should be a priority in the treatment of people with MS.
1Kobelt G, Thompson A, Berg J, et al. New insights into the burden and costs of multiple sclerosis in Europe. Mult Scler 2017; doi:10.1177/1352458517694432: 1352458517694432.