Contribution of intangible costs to the economic burden of multiple sclerosis

Figures & data

Table 1.  Characteristics of the populations in studies evaluating intangible costs of multiple sclerosis.

Study	Country (N)	Female, %	Mean age, years	MS type, %
				Relapsing- remitting	Progressive	Do not know/ no response
Henriksson et al., 200137	Sweden (409)	71	49.0	34	63	3
Kobelt et al., 200038	United Kingdom (619)	70.6	44.3	21.5	63.1	4.6
Kobelt et al., 20066	United States (1,909)	76.4	49.2	47.6	43.8	8.5
Kobelt et al., 200629	Austria (1,019)	70.4	50.0	35.6	55.1	9.4
Kobelt et al., 200631	Belgium (799)	68.0	48.1	38.2	45.7	16.1
Kobelt et al., 200630	Germany (2,793)	72.2	45.1	39.7	47.4	12.8
Kobelt et al., 200628	Italy (921)	65.8	46.1	35.4	50.7	13.9
Kobelt et al., 200627	Netherlands (1,549)	69.1	46.7	28.9	48.6	22.5
Kobelt et al., 200633	Spain (1,848)	64.2	44.7	37.3	45.5	17.3
Berg et al., 200634	Sweden (1,339)	73.0	53.4	21.4	67.7	10.9
Kobelt et al., 200632	Switzerland (1,101)	63.8	52.5	29.1	56.5	14.4
Kobelt et al., 20067	Nine European countries (13,186)	69.0	48.7	Not stated	Not stated	Not stated
Casado et al., 200723	Spain (211)	69.0	41.6	94.6	5.4	—

MS, multiple sclerosis.

Table 2.  Estimates of the intangible costs of multiple sclerosis.

Study	Mean EDSS score	Utility measure	QALYs lost	WTP threshold	Intangible costs per patient; cost year (proportion of total costs)*,†
Henriksson et al., 200137	4.9	EQ-5D	0.49	SEK 500,000 (=US $60,000)	SEK 245,636; 1998 (35.7%)
Kobelt et al., 200038	5.1	EQ-5D	0.383	£40,500 (=US $60,000)	£15,320; 1999 (47.8%)
Kobelt et al., 20066	Not stated	EQ-5D	0.255	US $60,000	US $15,315; 2004 (24.5%)
Kobelt et al., 200629	4.4	EQ-5D	0.273	€50,000	€13,650; 2004/2005 (25.3%)
Kobelt et al., 200631	3.9	EQ-5D	0.3	€50,000	€15,000; 2005 (31.6%)
Kobelt et al., 200630	3.8	EQ-5D	0.2	€50,000	€10,000; 2005 (24.4%)
Kobelt et al., 200628	4.6	EQ-5D	0.24	€50,000	€15,000; 2005 (27.9%)
Kobelt et al., 200627	3.9	EQ-5D	0.24	€50,000	€12,000; 2004/2005 (30.0%)
Kobelt et al., 200633	4.5	EQ-5D	0.276	€50,000	€13,817; 2004/2005 (29.2%)
Berg et al., 200634	5.1	EQ-5D	0.228	€50,000	€11,400; 2005 (17.5%)
Kobelt et al., 200632	4.5	EQ-5D	0.3	€50,000	CHF 23,000 (€15,000; 26.2%)
Kobelt et al., 20067	4.5	EQ-5D	0.27	€50,000; 3 × GDP	€13,400; €19,800
Casado et al., 200723	2.47	VAS	0.08	€55,000	€4,400

EDSS, Expanded Disability Status Scale; EQ-5D, EuroQol; GDP, gross domestic product; QALYs, quality-adjusted life-years; VAS, visual analogue scale; WTP, willingness-to-pay.

*Proportions may not sum to 100% due to missing values.

†Total costs = direct costs + indirect costs + intangible costs.

Figure 1.  Cross-national utility scores according to Expanded Disability Status Scale (EDSS) scores among nine countries in Europe. Although the EuroQol (EQ-5D) permits negative scores (i.e., health states worse than death), negative scores were set to zero. Reproduced with permission from Kobelt et al.7.

Figure 2.  Intangible costs and mean loss of quality-adjusted life-years (QALYs) as a function of Expanded Disability Status Scale (EDSS) scores in individuals with multiple sclerosis in a study in Spain. Estimations based on utility scores using the visual analogue scale component of the EuroQol (EQ-5D). Data from Casado et al.23.

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