Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-27T14:45:36.753Z Has data issue: false hasContentIssue false
  • English
  • Français

Burden of Illness of Multiple Sclerosis: Part I: Cost of Illness

Published online by Cambridge University Press:  18 September 2015

The Canadian Burden of Illness Study Group
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

Multiple sclerosis (MS) is a common neurologic disease in young and middle-aged adults affecting approximately 35,000 Canadians. The objectives of this study were to estimate the annual and lifetime costs of MS from the Canadian societal perspective.

Methods:

Patients were consecutively recruited by neurologists in 14 MS outpatient clinics across Canada. They were classified according to the Expanded Disability Status Scale (EDSS) into three groups: mild (EDSS ≤ 2.5), moderate (EDSS = 3.0-6.0) and severe (EDSS ≥ 6.5). Sociodemographic, clinical and resource utilization data were collected retrospectively for the three months prior to patient inclusion. Costing of resources was performed from Ministry of Health, private third party payers, patient and societal perspectives. Average Canadian costs ($CDN 1995) were valued from available provincial data.

Results:

A total of 198 patients were included in the analysis (mild: n = 62, moderate: n = 68 and severe: n = 68). Costs increased with increasing EDSS scores, from all perspectives. The annualized societal costs per patient were $CDN 14,523, $CDN21,698 and $CDN37,024 for the mild, moderate and severe groups, respectively. In all severity groups, most of the financial burden is borne by patients, from 74% to 88%. Indirect costs, namely lost daily activity/leisure time and lost productivity, were the major societal cost drivers. The lifetime cost of MS, including patient institutionalization, was estimated to be $CDN 1,608,000 per patient.

Conclusion:

In Canada, MS is associated with enormous direct and indirect costs. Patients carry most of the economic burden of this disease. The results of this burden of illness study provide a basis for cost-effectiveness analyses of new therapeutic interventions for MS.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 25 , Issue 1 , February 1998 , pp. 23 - 30
Copyright
Copyright © Canadian Neurological Sciences Federation 1998

References

REFERENCES

1.Hauser, SL. Multiple sclerosis and other demyelinating diseases. In: Isselbacher, KJ, Braunwald, E, Wilson, JD, Martin, JB, Fauci, AS, Kasper, DL , eds. Harrison’s Principles of Internal Medicine. Toronto: McGraw Hill Inc., 1994: 2281–2294.Google Scholar
2.Hibbard, PL. The use and misuse of statistics for epidemiological studies of multiple sclerosis. Ann Neurol 1994; 36(S2: S218–S230.Google Scholar
3.Becker, CC, Gidal, BE, Fleming, JO. Immunotherapy in multiple sclerosis, part 1. Am J Health-Syst Pharm 1995; 52: 1985–2000.CrossRefGoogle ScholarPubMed
4.Weinshenker, BG. The natural history of multiple sclerosis. Neurol Clin 1995; 13(1): 119–146.CrossRefGoogle ScholarPubMed
5.Weinshenker, BG, Bass, B, Rice, GPA, et al. The natural history of multiple sclerosis: a geographically based study. I. Clinical course and disability. Brain 1989; 112: 133–146.CrossRefGoogle Scholar
6.Sadovnick, AD, Ebers, GC, Wilson, RW, Paty, DW. Life expectancy in patients attending multiple sclerosis clinics. Neurology 1992; 42: 991–994.CrossRefGoogle ScholarPubMed
7.Sadovnick, AD, Ebers, GC. Epidemiology of multiple sclerosis: a critical overview. Can J Neurosci 1993; 20: 17–29.Google ScholarPubMed
8.Holmes, J, Mawick, T, Bates, D. The cost of multiple sclerosis. Brit J Med Econ 1995; 8: 181–193.Google Scholar
9.Bourdette, DN, Prochazcha, AV, Mitchell, W, Licari, P, Burks, J. VA MS Rehabilitation Study Group. Health care costs of veterans with MS: implications for the rehabilitation of MS. Arch Phys MedRehabil 1993; 74: 25–31.Google ScholarPubMed
10.Inman, RP. Disability indices, the economic costs of illness and social insurance: the case of multiple sclerosis. Acta Neurol Scand Suppl 1984; 70: 46–55.CrossRefGoogle Scholar
11.Bauer, HJ, Firnhaber, W, Winkler, W. Prognostic criteria in multiple sclerosis. Ann NY Acad Sci 1965; 122(1): 542–551.CrossRefGoogle ScholarPubMed
12.Kornblith, AB, La Rocca, NG, Baum, HM.Employment in individuals with multiple sclerosis. Int J Rehab Research 1986; 9(2): 155–165.CrossRefGoogle ScholarPubMed
13.Poser, CM, Paty, DW, Scheinberg, L, et al. New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol 1983; 13: 227–231.CrossRefGoogle ScholarPubMed
14.Koopmanschap, MA, Rutten, FFH. A practical guide for calculating indirect cost of disease. PharmacoEconomics 1996; 10(5): 460–466.CrossRefGoogle Scholar
15.Posnett, J, Jan, S. Indirect costs in economic evaluation: the opportunity cost of unpaid inputs. Health Econ 1996; 5: 3–23.3.0.CO;2-J>CrossRefGoogle ScholarPubMed
16.Drumond, MF. Resource allocation decisions in health care: a role for quality of life assessments? J Chron Dis 1987; 40(6): 605–616.CrossRefGoogle Scholar
17.Statistics Canada. Catalogue 71–001. Labour Force Catalogue, 1996.Google Scholar
18.Statistics Canada. Catalogue 93–301. A National Overview: Population Dwelling Counts, 1993.Google Scholar
19.Statistics Canada. Catalogue 84–537. Table de mortalité: Canada et provinces, 1990–1992.Google Scholar
20.Weinshenker, BG, Bass, B, Rice, GPA, et al. The natural history of multiple sclerosis: a geographically based study: 4. Applications to planning and interpretation of clinical therapeutic trials. Brain 1991; 114: 1057–1067.CrossRefGoogle ScholarPubMed
21.Freund, DA, Dittus, RS. Principles of pharmacoeconomic analysis of drug therapy. PharmacoEconomics 1992; 1(1): 20–32.CrossRefGoogle ScholarPubMed
22.Ministry of Health Finance and Administration Division. Fiscal Strategies Branch. Authorized rates 1996–1997 Public Hospitals.Google Scholar
23.Hohol, MJ, Orav, EJ, Weiner, HL. Disease steps in multiple sclerosis. Neurology 1995; 45: 251–255.CrossRefGoogle ScholarPubMed
24.Lynch, S, Rose, J. Multiple sclerosis. Disease-a-month 1996; 42(1): 3–55.CrossRefGoogle ScholarPubMed
25.Drummond, MF, Stoddart, GL, Torrance, GW, eds. Cost effectiveness analysis. In: Methods for the economic evaluaton of health care programmes. New York: Oxford University Press, 1986: 75–111.Google Scholar
26.Statistics Canada. Catalogue 13–207. Annual Income Distribution by Size in Canada, 1994.Google Scholar
27.Statistics Canada. Catalogue 95–326. Profile of census divisions and sub-divisions in Quebec: Part B, 1991.Google Scholar
28.Scheinberg, L, Holland, N, La Rocca, N, et al. Multiple sclerosis: earning a living. Arch Neurol 1982; 39: 1395–1401.Google Scholar
29.Mitchell, JN. Multiple sclerosis and the prospects for employment. J Soc Occup Med 1981; 31: 134–138.CrossRefGoogle ScholarPubMed
30.Catanzaro, M, Weinert, C. Economic status of patients living with multiple sclerosis. Int J Rehab Research 1992; 15: 209–218.CrossRefGoogle Scholar
31.Krahn, MD, Berka, C, Langlois, P, Detsky, AS. Direct and indirect costs of asthma in Canada, 1990. Can Med Assoc J 1996; 154: 821–831.Google ScholarPubMed
32.Glaxo Canada Inc. The Costs of Adult Asthma in Canada; Comm. Media for Educ, Inc.; 1993.Google Scholar
33.Dales, RE, Raizenne, M, El-Saadany, S, Brook, J, Burnett, R. Prevalence of Childhood Asthma across Canada. Int J Epidemiol 1994; 23(4): 775–781.CrossRefGoogle ScholarPubMed
34.Compston, A. Beta-interferon and multiple sclerosis: not a final solution to the problem. Brit J Hosp Med 1995; 53(11): 547–553.Google Scholar
35.According to internal estimates by Berlex Canada, Inc. Data on file at Berlex.Google Scholar
36.British Columbia Ministry of Health. BCMA Schedule of Costs by Fiscal Year. British Columbia: Medical Services Plan, 1994.Google Scholar
37.Alberta Health. Schedule of Medical Benefits. Alberta: Health Care Insurance Plan, 1994.Google Scholar
38.Saskatchewan Health. Payment Schedule for Physician Service. Saskatchewan: Medical Care Insurance Branch, 1996.Google Scholar
39.Manitoba Health. Physician’s Manual. Manitoba: Health Services Insurance Plan, 1996.Google Scholar
40.Ontario Ministry of Health. Schedule of Benefits/Physician Services. Ontario: Health Insurance Act, 1992.Google Scholar
41.Ministère de la Santé et des Services Sociaux. Centres Hospitaliers Publics-Listes 1994–1995. Quebec.Google Scholar
42.Direction Général du Budget et de 1’Administration/Direction de la Planification et des Stratégies de Financement, 1995.Google Scholar
43.Ministère de la Santé et des Services Sociaux. Manuel des Médecins Omnipraticiens. Québec: La Régie de 1’Assurance-Maladie, 1995.Google Scholar
44.Ministère de la Santé et des Services Sociaux. Manuel des Médecins Specialistes. Québec: La Régie de 1’Assurance-Maladie, 1995.Google Scholar
45.Maritime Medical Care Incorporated. Physician’s Manual. Nova Scotia: Medical Services Insurance, 1994.Google Scholar
46.Maritime Medical Care Incorporated. Laboratory Credit Schedule. Nova Scotia: Department of Health & Fitness, 1994.Google Scholar
47.Pharmacare. Low Cost Alternative/Reference Based Pricing List. British Columbia: Pharmacare, 1995.Google Scholar
48.Alberta Health. Drug Benefits List. Alberta: Family and Social Services, 1994.Google Scholar
49.Saskatchewan Health. Drug Formulary. Saskatchewan: Prescription Drug Services, 1996.Google Scholar
50.Manitoba Health. Drug Benefits And Interchangeability Formulary. Manitoba: Drug Standards & Therapeutics Committee, 1996.Google Scholar
51.Ontario Ministry of Health. Drug Benefits Formulary/Comparative Drug Index. Ontario: Publication Ontario, 1995.Google Scholar
52.Association Québecoise des Pharmaciens Propriétaires. Listes de Médicaments-AQPP. Montréal: Association Québécoise des Pharmaciens Propriétaires, 1996.Google Scholar
53.Services des Communications. Listes de Médicaments-4e Éditions. Québec: La Régie de l’Assurance-Maladie, 1996.Google Scholar
54.Nova Scotia Pharmacare. Maximum Allowable Cost List. Nova Scotia: Pharmacare Program, 1994.Google Scholar