The cost burden of multiple sclerosis in the United States: a systematic review of the literature

Abstract

Objectives:

To estimate average annual cost per multiple sclerosis (MS) patient in the US using published estimates from the literature.

Methods:

A search was performed of English-language literature published between 2007 and June 2012 in PubMed and Embase using the term ‘multiple sclerosis’ and the subject heading ‘healthcare costs’. Included articles were primary studies with MS cost figures that could be converted to per patient per year values. Costs were inflated to 2011 dollars using the medical component of the Consumer Price Index.

Results:

Fifteen studies met the inclusion criteria. Eight presented only direct cost calculations; the remaining seven presented estimates of total cost, broken down into direct and indirect costs. Total all-cause healthcare costs for MS as reported by studies that included direct and indirect costs ranged from $8528–$54,244 per patient per year. On average, direct costs comprised 77% (range 64–91%) of total costs. Prescription medications accounted for the majority of direct costs. On average, indirect costs comprised 23% (range 9–36%) of total costs. Compared with direct all-cause medical costs for other chronic conditions reported in the literature, MS ranked second behind congestive heart failure.

Limitations:

Data sources in these studies were dated, ranging from 1999–2008, and therefore do not include some of the newer, more costly therapies. In addition, this review does not include either assessment of the decrements in quality-of-life associated with MS or costs associated with increasing levels of disability or early retirement. Furthermore, variations in study designs, populations, methodologies, and cost inputs preclude more precise cost estimates.

Conclusions:

MS is a costly chronic disease. Further research is needed to understand: costs by MS type, costs associated with increasing disability and early retirement, and the potential impact of new treatments expected to launch in coming years.

Keywords::

• Multiple sclerosis
• Healthcare costs
• Direct costs
• Indirect costs
• United States

Transparency

Declaration of funding

All activities relating to this study were conducted internally within Genentech, Inc. GA and KV were responsible for the literature review. All authors contributed to the interpretation of the data and writing of the manuscript.

Declaration of financial/other relationships

KV and SGR are employees of Genentech, Inc. GA was an employee of Genentech, Inc. at the time of authorship.

Acknowledgments

Support for third-party writing assistance for this manuscript was provided by F. Hoffmann-La Roche Ltd.