The Economic and societal burden of multiple sclerosis on lebanese society: a cost-of-illness and quality of life study protocol

ABSTRACT

This protocol describes the estimation of the societal costs and quality-of-life (QOL) burden of multiple sclerosis (MS) in Lebanon. This cross-sectional, prevalence-based burden-of-illness study was carried out in a premier MS center in Lebanon. We enrolled Lebanese patients aged 18 years and older who had been diagnosed with MS more than 6 months. The study uses a bottom-up approach to estimate the cost-of-illness (COI) and QOL using a retrospective face-to-face interview questionnaire. This resource utilization questionnaire was adapted to the Lebanese context by clinical and health economics experts. The methodologies used to estimate the consumption of healthcare resources, informal care, and productivity losses are well-defined and aligned with the Lebanese healthcare system. Costs are presented overall and by MS severity levels. QOL is measured using the EuroQOL (EQ-5D-5 L) and Multiple Sclerosis International Quality of Life (MusiQoL) instrument. This protocol pioneers in informing the design of future COI and QOL studies in low – and middle-income countries (LMICs), as the methods used could be applied in similar LMICs. Furthermore, we provide recommendations and discuss the challenges of conducting a high-quality burden-of-illness study in LMICs and the steps taken to meet them, using the case of Lebanon.

KEYWORDS:

• Cost-of-illness
• economic burden
• Lebanon
• multiple sclerosis
• study protocol
• utilities

Supplemental data

Supplemental data for this article can be accessed here.

Funding

This paper was not funded.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Author contributions

All authors were involved in the concept and design. J Dahham drafted the manuscript. The Multiple Sclerosis Health Resource Use Questionnaire was adapted to the Lebanese healthcare system by all the study authors (J Dahham, R Rizk, M Hiligsmann, C Daccache, S Evers, I Kremer health economics experts) and (S Khoury and H Darwish clinical neurology experts practicing in Lebanon). All authors reviewed and edited the manuscript and approved the final version of the manuscript. All authors agree for the final version to be published and to be accountable for all aspects of the work.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.