Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan;38(1):758-771.
doi: 10.1007/s12325-020-01570-0. Epub 2020 Nov 27.

Annual Cost Burden by Level of Relapse Severity in Patients with Multiple Sclerosis

Affiliations

Annual Cost Burden by Level of Relapse Severity in Patients with Multiple Sclerosis

Jacqueline Nicholas et al. Adv Ther. 2021 Jan.

Abstract

Introduction: The severity of relapses varies in multiple sclerosis (MS) and may lead to a differential cost burden. This study aimed to characterize the direct healthcare costs associated with relapses in patients with MS by the level of relapse severity.

Methods: This retrospective analysis used claims data extracted from the MarketScan® Databases from January 1, 2013 to March 31, 2017 (study period January 1, 2012 to March 31, 2018). Adult patients with at least one diagnosis of MS and 12 months of continuous enrollment prior to the first MS diagnosis to 12 months after the index date were included. On the basis of the severity of the relapse, patients were stratified into three cohorts: severe relapse (SR), mild/moderate relapse (MMR), and no relapse (NR). All-cause and MS-related costs were analyzed during the 12-month follow-up period. Group differences were assessed using descriptive and multivariate statistical analyses.

Results: In total, 8775 patients with MS were analyzed: 6341 (72%) in the NR cohort, 1929 (22%) in the MMR cohort, and 505 (6%) in the SR cohort. Overall, patients were mostly female (76%), mean age was 50 years, and 25% were on a disease-modifying therapy. Mean (standard deviation [SD]) all-cause and MS-related costs among patients with a relapse were higher vs patients without a relapse (all-cause $66,489 [$56,264] vs $41,494 [$48,417]; MS-related $48,700 [$43,364] vs $24,730 [$33,821]). Among patients with a relapse, the mean (SD) all-cause costs were $87,979 [$65,991] vs $60,863 [$51,998] and MS-related costs were $69,586 ($51,187) vs $43,233 [$39,292] for patients in the SR vs MMR cohorts, respectively. A similar trend for increase in cost by relapse severity was observed in the adjusted analysis.

Conclusion: Total annual all-cause and MS-related costs increased with severity of the relapses. High-efficacy treatments might reduce the severity of the relapses, thereby reducing the cost of care in patients with MS.

Keywords: Healthcare costs; Multiple sclerosis; Relapse; Severity.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Study design. ER emergency room, MS multiple sclerosis
Fig. 2
Fig. 2
Patient flow. CM clinical modification, ICD International Classification of Diseases, MS multiple sclerosis

References

    1. GBD 2016 Multiple Sclerosis Collaborators Global, regional, and national burden of multiple sclerosis 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet Neurol. 2019;18:269–285. doi: 10.1016/S1474-4422(18)30443-5. - DOI - PMC - PubMed
    1. Dilokthornsakul P, Valuck RJ, Nair KV, Corboy JR, Allen RR, Campbell JD. Multiple sclerosis prevalence in the United States commercially insured population. Neurol. 2016;86:1014–1021. doi: 10.1212/WNL.0000000000002469. - DOI - PMC - PubMed
    1. Hirst C, Ingram G, Pearson O, Pickersgill T, Scolding N, Robertson N. Contribution of relapses to disability in multiple sclerosis. J Neurol. 2008;255:280–287. doi: 10.1007/s00415-008-0743-8. - DOI - PubMed
    1. Lublin FD, Baier M, Cutter G. Effect of relapses on development of residual deficit in multiple sclerosis. Neurol. 2003;61:1528–1532. doi: 10.1212/01.WNL.0000096175.39831.21. - DOI - PubMed
    1. Confavreux C, Vukusic S, Moreau T, Adeleine P. Relapses and progression of disability in multiple sclerosis. N Engl J Med. 2000;343:1430–1438. doi: 10.1056/NEJM200011163432001. - DOI - PubMed

Publication types