Impact of multiple sclerosis phenotypes on burden of disease in Finland

Abstract

Aims: The aim of this study was to quantify how multiple sclerosis (MS) phenotypes differ from each other in respect of costs and quality-of-life.

Materials and methods: The study is based on survey data from Finnish patients with MS (n = 553). The information contained disease type, disease severity according to self-reported Expanded Disease Severity Scale (EDSS), healthcare resource use, and medication use. In addition, information related to employment and early retirement was collected. EQ-5D-VAS and Multiple Sclerosis Impact Scale-29 (MSIS-29) instruments were used to collect quality-of-life data, and Fatigue Severity Scale (FSS) instrument for evaluating fatigue. Patients were stratified based on their disease type (relapsing-remitting MS (RRMS), secondary progressive MS (SPMS), primary progressive MS (PPMS)) and disease severity. The data were primarily analyzed using summary statistics.

Results: SPMS had the highest annual total cost (71,177€) followed by PPMS (51,082€) and RRMS (36,492€). Early retirement covered the greatest share of costs in RRMS (39%) and SPMS (43%). In PPMS, early retirement and professional care were the two most equally important cost drivers, contributing together 56% of the total costs. Direct healthcare costs were responsible for 33%, 19%, and 18% of total costs in RRMS, SPMS, and PPMS. The mean EDSS in RRMS, SPMS, and PPMS were 2.5, 5.5, and 5.9, respectively. Differences in the quality-of-life were observed with both disease specific (MSIS-29) and generic (EQ-5D-VAS) instruments. The mean utility value from EQ-5D among patients with RRMS, SPMS, and PPMS was 0.76, 0.52, and 0.49, respectively. In addition, patients with SPMS and PPMS were more likely to report fatigue than patients with RRMS.

Conclusions: MS phenotype has an impact on costs and quality-of-life of the patients. Early retirement seems to be one of the most important contributors to MS-related costs.

Keywords:

• Multiple sclerosis
• costs
• quality-of-life
• disease modifying treatments
• relapsing remitting MS
• secondary progressive MS
• primary progressive MS

JEL CLASSIFICATION CODES:

• I19
• I10

Transparency

Declaration of funding

This research was initiated and funded by Novartis Finland Oy.

Declaration of financial/other relationships

TP and TH are paid employees of Novartis Finland Oy. MT is a paid employee of StatFinn Oy, which provides statistical services for pharmaceutical companies. JR is a paid employee of the Finnish Neuro Society. A peer reviewer on this manuscript has disclosed that they are, or have been, a speaker for all manufacturers of MS DMTs. The peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Acknowledgements

None reported.