Health-related outcomes, health care resource utilization, and costs of multiple sclerosis in Japan compared with US and five EU countries

Abstract

Purpose

Multiple sclerosis (MS) imposes a huge burden on patients. This study examined the relationship between MS and health-related and economic burden in Japan; secondarily, health status was compared across patients with MS in Japan, US, and five European Union (5EU) countries (France, Germany, Italy, Spain, and UK).

Methods

A retrospective cross-sectional study was conducted using self-reported data from 2009 to 2014 Japan National Health and Wellness Survey (n=145,759). Health status, work productivity loss, activity impairment, health care resource utilization, and annual costs associated with MS (n=85) were compared with controls without MS (n=145,674). Propensity score matching and multivariable linear regressions determined the effect of MS after controlling for confounders. Health status in Japan was also compared with that of 5EU (n=62) and US (n=67) patients with MS.

Results

Patients with MS in Japan reported significantly worse health status via mental component summary score (MCS; 40.1 vs 45.8) and physical component summary score (PCS; 41.4 vs 51.2) and health state utility scores (0.63 vs 0.74; all P<0.001). They also reported more absenteeism (12.0% vs 3.7%), presenteeism (33.8% vs 19.8%), overall work impairment (40.9% vs 21.6%), and activity impairment (43.6% vs 24.0%), with higher indirect costs (¥2,040,672/US $20,102 vs ¥1,076,306/US$10,603) than controls (all P<0.001). Patients with MS reported higher resource use, including provider visits (8.0 vs 4.7), emergency room visits (0.03 vs 0.1), and hospitalizations (2.7 vs 0.69) in the past 6 months, with higher direct costs (¥3,670,906/US$36,162 vs ¥986,099/US$9,714) than controls (all P<0.001). Finally, Japanese patients with MS reported lower MCSs and higher PCSs than their US and 5EU counterparts.

Conclusion

MS in Japan is associated with poor health status and high work productivity loss, resource use, and costs, underscoring the need for improved treatment, especially vis-à-vis mental health, when comparing Japanese patients with their 5EU and US counterparts.

Keywords:

• activity impairment
• direct costs
• health care resource utilization
• health status
• indirect costs
• work productivity impairment

Acknowledgments

The authors acknowledge Urmila Rao, PhD, and Ramu Periyasamy, PhD, from Indegene Pvt Ltd. for their assistance with literature review and writing, as well as Martine C Maculaitis, PhD, for editing assistance on behalf of Kantar Health. This research was funded by Takeda Pharmaceutical Company Limited.

Author contributions

Kaoru Yamabe: study design, data analysis, interpretation, and manuscript development. Marco DiBonaventura: study design, data analysis, interpretation, and manuscript development. Chris Pashos: data analysis, interpretation, and manuscript development. All authors contributed to data analysis, drafting and revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

Kaoru Yamabe is an employee of Takeda Pharmaceutical Company Limited. Marco DiBonaventura, at the time of this study, was an employee of Kantar Health, a paid consultant of Takeda Pharmaceutical Company Limited. Chris Pashos is an employee of Takeda Pharmaceuticals International Co. The authors report no other conflicts of interest in this work.