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. 2003 Sep 2;3(1):17.
doi: 10.1186/1472-6963-3-17.

Cost of managing an episode of relapse in multiple sclerosis in the United States

Judith A O'Brien  1 , Alexandra J Ward, Amanda R Patrick, Jaime Caro
Affiliations

Cost of managing an episode of relapse in multiple sclerosis in the United States

Judith A O'Brien et al. BMC Health Serv Res. .

Abstract

Background: The purpose of this study was to determine the direct medical US cost of managing multiple sclerosis relapses.

Methods: Direct data analysis and cost modeling were employed to derive typical resource use profiles and costs in 2002 US dollars, from the perspective of a third-party payer responsible for comprehensive health-care. The location and scope of health care services provided over a 90-day period were used to define three levels of relapse management. Hospitalization and resulting subsequent care was defined as high intensity management. A medium level of intervention was defined as either use of the emergency room, an observational unit, or administration of acute treatments, such as intravenous methylprednisolone in an outpatient or home setting. The lowest intensity of care comprised physician office visits and symptom-related medications. Data were obtained from many sources including all payer inpatient, ambulatory and emergency room databases from several states, fee schedules, government reports, and literature. All charges were adjusted using cost-to-charge ratios.

Results: Average cost per person for high management level was 12,870 dollars, based on analysis of 4,634 hospital cases (mean age 48 years, 73% female). Hospital care comprised 71% of that cost. At discharge, 36% required inpatient sub-acute care, rehabilitation or home care. The typical cost per moderate episode was 1,847 dollars and mild episode 243 dollars.

Conclusions: Management strategies leading to a reduction in the frequency and severity of a relapse, less reliance on inpatient care, or increased access to steroid infusions in the home, would have a substantial impact on the economic consequences of managing relapses.

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Figures

Figure 1
Figure 1
Overview of health care services and resource use profiles used to define management levels during a 90-day relapse episode
Figure 2
Figure 2
Distribution of multiple sclerosis cases from state databases by primary payer
Figure 3
Figure 3
Proportion of overall high-level management cost by major cost components
Figure 4
Figure 4
Proportion of overall medium level management cost by major cost components
See this image and copyright information in PMC

References

    1. National Institute of Neurological Disorders and Stroke. Multiple Sclerosis: Hope Through Research. NIH. 2002. http://www.ninds.nih.gov/health_and_medical/pubs/multiple_sclerosis.htm
    1. Runmarker B, Andersen O. Prognostic factors in a multiple sclerosis incidence cohort with twenty-five years of follow-up. Brain. 1993;116:117–164. - PubMed
    1. Weinshenker BG, Bass B, Rice GP, Noseworthy J, Carriere W, Baskerville J, Ebers GC. The natural history of multiple sclerosis: a geographically based study. 2. Predictive value of the early clinical course. Brain. 1989;112:1419–1428. - PubMed
    1. Whetten-Goldstein K, Sloan FA, Goldstein LB, Kulas ED. A comprehensive assessment of the cost of multiple sclerosis in the United States. Multiple Sclerosis. 1998;4:419–425. doi: 10.1191/135245898678919401. - DOI - PubMed
    1. Lacy JR, Stuart WH, Jacobs LD, Vartanian T, Phillips JT, Greenstein JI. Registry of Multiple Sclerosis Treatment and Care (MSTRAC) Patient and Physician Characteristics. Int J MS Care. 2000;2 http://www.mscare.com/a0012/page_04.htm

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