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. 2019 Mar 5;92(10):e1029-e1040.
doi: 10.1212/WNL.0000000000007035. Epub 2019 Feb 15.

The prevalence of MS in the United States: A population-based estimate using health claims data

Mitchell T Wallin  1 , William J Culpepper  2 , Jonathan D Campbell  2 , Lorene M Nelson  2 , Annette Langer-Gould  2 , Ruth Ann Marrie  2 , Gary R Cutter  2 , Wendy E Kaye  2 , Laurie Wagner  2 , Helen Tremlett  2 , Stephen L Buka  2 , Piyameth Dilokthornsakul  2 , Barbara Topol  2 , Lie H Chen  2 , Nicholas G LaRocca  2 ; US Multiple Sclerosis Prevalence Workgroup
Affiliations

The prevalence of MS in the United States: A population-based estimate using health claims data

Mitchell T Wallin et al. Neurology. .

Erratum in

Abstract

Objective: To generate a national multiple sclerosis (MS) prevalence estimate for the United States by applying a validated algorithm to multiple administrative health claims (AHC) datasets.

Methods: A validated algorithm was applied to private, military, and public AHC datasets to identify adult cases of MS between 2008 and 2010. In each dataset, we determined the 3-year cumulative prevalence overall and stratified by age, sex, and census region. We applied insurance-specific and stratum-specific estimates to the 2010 US Census data and pooled the findings to calculate the 2010 prevalence of MS in the United States cumulated over 3 years. We also estimated the 2010 prevalence cumulated over 10 years using 2 models and extrapolated our estimate to 2017.

Results: The estimated 2010 prevalence of MS in the US adult population cumulated over 10 years was 309.2 per 100,000 (95% confidence interval [CI] 308.1-310.1), representing 727,344 cases. During the same time period, the MS prevalence was 450.1 per 100,000 (95% CI 448.1-451.6) for women and 159.7 (95% CI 158.7-160.6) for men (female:male ratio 2.8). The estimated 2010 prevalence of MS was highest in the 55- to 64-year age group. A US north-south decreasing prevalence gradient was identified. The estimated MS prevalence is also presented for 2017.

Conclusion: The estimated US national MS prevalence for 2010 is the highest reported to date and provides evidence that the north-south gradient persists. Our rigorous algorithm-based approach to estimating prevalence is efficient and has the potential to be used for other chronic neurologic conditions.

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Figures

Figure 1
Figure 1. Average annual prevalence of MS in the United States for 2008, 2009, and 2010 per 100,000 population for private (OP and TH, black lines) and government (Medicaid, Medicare, and VA, red lines) health insurance datasets
Multiple sclerosis (MS) cases acquired from the MS algorithm in year 1 are displayed, along with new cases added cumulatively in subsequent years. OP = Optum; TH = Truven Health; VA = Department of Veterans Affairs.
Figure 2
Figure 2. 2010 Prevalence for MS cumulated over 10 years in the United States per 100,000 population by age and sex
Higher and lower estimates adjusted to 2010 US Census based on combined datasets from the multiple sclerosis (MS) algorithm inclusive of the following: Truven, Optum, Department of Veterans Affairs, Medicare, and Medicaid (full data available for all age and sex estimates in data table e-7 available from Dryad, https://doi.org/10.5061/dryad.pm793v8). (A) Lower-estimate and (B) higher-estimate 2010 MS prevalence in the United States per 100,000 population.
Figure 3
Figure 3. High-estimate 2010 prevalence of MS in the United States per 100,000 population (2010 US Census) by Census region with 95% CI and F:M prevalence ratio
CI = confidence interval; F:M = female:male; MS = multiple sclerosis.
See this image and copyright information in PMC

References

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