TREATMENT EXPERIENCE, BURDEN, AND UNMET NEEDS (TRIBUNE) IN MULTIPLE SCLEROSIS STUDY: THE COSTS AND UTILITIES OF MS PATIENTS IN CANADA

Main Article Content

Korinna Karampampa
Anders Gustavsson
Carolin Miltenburger
Christian M Kindundu
Daniel H Selchen

Keywords

Multiple sclerosis, MS, costs, cost-of-illness, utilities, quality of life, QoL, Canada

Abstract

Background


Multiple sclerosis (MS) is the most common neurological disease among young adults in Canada, but few studies to date have measured the burden imposed by MS on Canadian society.


 


Objectives


To estimate the costs and quality of life of MS patients in Canada, while focusing on the burden of relapses and increasing disease severity.


 


Methods


MS patients in Canada (N=241) completed a web-based questionnaire which captured information on demographics, disease characteristics, severity (Expanded Disability Status Scale [EDSS]), comorbidities, relapses, as well as resource consumption and quality of life associated with MS.


 


Results


Most patients (74%) reported treatment with disease modifying therapies (DMTs). 54% of patients with the relapsing-remitting form of the disease with an EDSS score ? 5 had experienced at least one relapse in the past year. The mean cost per patient per year increased with worsening disability, and was estimated at Can $30,836 for patients with mild disability (EDSS score 0-3), Can $46,622 for patients with moderate disability (EDSS 4-6.5), and Can $77,981 for patients with severe disability due to MS (EDSS score 7-9). The excess costs of relapsing-remitting MS patients with EDSS score ? 5 that could be attributable to relapse(s) were estimated at Can $10,512. More severe disease and experiencing a relapse were also associated with poorer quality of life of MS patients.


 


Conclusions


Costs of MS patients are higher today than shown in previous studies. Disease progression and relapses are associated with increased economic and quality of life burden. Effective treatment that reduces relapse frequency and prevents progression could impact both costs and quality of life and may help to reduce the societal burden of MS.

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References

1. Multiple Sclerosis Society of Canada. About MS. (2010) http://mssociety.ca/en (Access date: November 18, 2010).
2. Multiple Sclerosis International Federation. Atlas of MS Database. (2009) http://www.atlasofms.org/index.aspx (Access date: November 10, 2010).
3. Compston A, Coles A. Multiple sclerosis. Lancet 2008;372:1502-17.
4. Burden of illness of multiple sclerosis: Part II: Quality of life. The Canadian Burden of Illness Study Group. Can J Neurol Sci 1998;25:31-8.
5. Henriksson F, Fredrikson S, Masterman T, Jonsson B. Costs, quality of life and disease severity in multiple sclerosis: a cross-sectional study in Sweden. Eur J Neurol 2001;8:27-35.
6. Burden of illness of multiple sclerosis: Part I: Cost of illness. The Canadian Burden of Illness Study Group. Can J Neurol Sci 1998;25:23-30.
7. Canadian Institute for Health Information. The Burden of Neurological Diseases, Disorders and Injuries in Canada. (2007) http://mssociety.ca/en/pdf/banhc-impactreport- 200706_EN.pdf (Access date: March 12, 2010).
8. Grima DT, Torrance GW, Francis G, Rice G, Rosner AJ, Lafortune L. Cost and health related quality of life consequences of multiple sclerosis. Mult Scler 2000;6:91-8.
9. Sormani MP, Bonzano L, Roccatagliata L, Mancardi GL, Uccelli A, Bruzzi P. Surrogate endpoints for EDSS worsening in multiple sclerosis. A meta-analytic approach. Neurology 2010;75:302-9.
10. Kurtzke JF. A new scale for evaluating disability in multiple sclerosis. Neurology 1955;5:580-3.
11. The EuroQol Group. EuroQol--a new facility for the measurement of health-related quality of life. Health Policy 1990;16:199-208.
12. Bank of Canada. Harmonized Price Indices. (2010) http://www.bankofcanada.ca/pdf/nrma09-12.pdf. (Access date: April 14,2010)
13. Ontario Ministry of Health and Long-Term Care. Ontario Case Costing Initiative. (OCCI). (2008) www.occp.com (Access date: April 12, 2010).
14. Ontario Ministry of Health and Long-Term Care. Ontario Schedule of Benefits for Physician Services. (2009) http://www.health.gov.on.ca/english/providers/p rogram/ohip/sob/physserv/physserv_mn.html (Access date: April 12, 2010).
15. Price List of Pharmaceuticals in Quebec. Liste de medicaments publiee par la Regie de l'assurance maladie du Quebec. (2010) http://www.ramq.gouv.qc.ca/fr/professionnels/m edicaments/listmed/pdf/modification/liste_medic aments.pdf. (Access date: April 12, 2010).
16. Ontario Ministry of Health and Long-Term Care. Ontario Drug Benefit Formulary. (2010) http://www.health.gov.on.ca/english/providers/p rogram/drugs/odbf_eformulary.html. (Access date: March 11, 2010).
17. Community Care Access Centre. Toronto Central. (2009) www.toronto.ccac-ont.ca (Access date: May 6, 2011).
18. London Health Sciences Centre. Case Costing Fiscal Year 2009. (2009) http://www.lhsc.on.ca/About_Us/Case_Costing/index.htm (Access date: May 6, 2011).
19. Shoppers Home Health Care, New Street Burlington, Ontario. 3-5-2010.
20. Statistics Canada. Average hourly wages of Canadian employees in January 2010. (2010) http://www40.statcan.ca/l01/cst01/labr69aeng. htm (Access date: March 11, 2010).
21. Organization for Economic Co-operation and Development (OECD). Labour Force Statistics: Average annual hours actually worked per worker, 2008. (2011) http://stats.oecd.org (Access date: May 6, 2011).
22. Organization for Economic Co-operation and Development (OECD). Social and Welfare Statistics: Income Distribution, 2008. (2011) http://stats.oecd.org (Access date: May 6, 2011).
23. Kobelt G, Berg J, Lindgren P, Fredrikson S, Jonsson B. Costs and quality of life of patients with multiple sclerosis in Europe. J Neurol Neurosurg Psychiatry 2006;77:918-26.
24. Kobelt G, Berg J, Atherly D, Hadjimichael O. Costs and quality of life in multiple sclerosis: a cross-sectional study in the United States. Neurology 2006;66:1696-702.
25. Dolan P, Gudex C, Kind P, Williams A. A Social Tariff for EuroQol: Results from a UK General Population Survey. York: Centre for Health Economics, University of York, 1995.
26. Davison A, Hinkley D. Bootstrap Methods and their Application (8th Edition). Cambridge University Press, Cambridge, UK. 2006.
27. Fay MP, Proschan MA. Wilcoxon-Mann- Whitney or t-test? On assumptions for hypothesis tests and multiple interpretations of decision rules. Stat Surv 2010;4:1-39.
28. Fisk JD, Brown MG, Sketris IS, Metz LM, Murray TJ, Stadnyk KJ. A comparison of health utility measures for the evaluation of multiple sclerosis treatments. J Neurol Neurosurg Psychiatry 2005; 76:58-63.
29. McCrone P, Heslin M, Knapp M, Bull P, Thompson A. Multiple sclerosis in the UK: service use, costs, quality of life and disability. Pharmacoeconomics 2008;26:847-60.