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. 2022 Apr 24;8(2):20552173221092411.
doi: 10.1177/20552173221092411. eCollection 2022 Apr-Jun.

Early vs. late treatment initiation in multiple sclerosis and its impact on cost of illness: A register-based prospective cohort study in Sweden

Korinna Karampampa  1 , Hanna Gyllensten  1 , Chantelle Murley, Kristina Alexanderson, Andrius Kavaliunas, Tomas Olsson, Ali Manouchehrinia, Jan Hillert, Emilie Friberg  1
Affiliations

Early vs. late treatment initiation in multiple sclerosis and its impact on cost of illness: A register-based prospective cohort study in Sweden

Korinna Karampampa et al. Mult Scler J Exp Transl Clin. .

Abstract

Background: Early treatment with disease modifying therapies (DMTs) for multiple sclerosis (MS) has been associated with lower disability progression; the aim was to explore its association with cost of illness (COI) in MS.

Methods: All people with relapsing-remitting MS in the Swedish MS register, aged 20-57 years and receiving their first MS DMT in 2006-2009, were followed in nationwide registers for 8 years. Healthcare costs (in- and outpatient healthcare, DMTs and other prescribed drugs), and productivity losses (sickness absence and disability pension) of individuals receiving therapy in ≤6 months after diagnosis (early treatment group) were compared to those receiving therapy >6 months (late treatment group). Using Poisson regressions, the mean COI per patient per year, and per group, was estimated, adjusted for disability progression.

Results: The early treatment group comprised 74% of the 1562 individuals included in the study. The early treatment group had lower productivity losses over time. Both groups had similar healthcare costs, which first increased and then decreased over time.

Conclusions: Early DMT in MS could result in lower productivity losses possibly through maintained work capacity. COI serves as an objective measure showing the advantage of early vs. late treatment initiation in MS.

Keywords: COI; Multiple sclerosis; cost of illness; costs; early treatment.

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Conflict of interest statement

Declaration of conflicting interests: All authors (KK, HG, CM, KA, JH, AK, TO, AM, EF) are employed or affiliated at the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. KK is currently employed by Celgene/Bristol Myers Squibb; she initiated this study while being employed at Karolinska Institutet (employment ended in October 2019); since then, she has not received any salary from Karolinska Institutet or other type of funding for this research. HG is currently employed part-time by Statfinn/EPID Research (which is part of IQVIA); both companies are contract research organizations that perform commissioned pharmaco-epidemiological studies, and therefore are collaborating with several pharmaceutical companies. CM's employment at Karolinska Institutet is partly funded by research grant from Biogen. AM is supported by Margaretha af Ugglas foundation. KA has received unrestricted MS research grants from Biogen. JH has received honoraria for serving on advisory boards for Biogen, Celgene, Sanofi-Genzyme, Merck KGaA, Novartis and Sandoz and speaker's fees from Biogen, Novartis, Merck KGaA, Teva and Sanofi-Genzyme. He has served as P.I. for projects, or received unrestricted research support from, Biogen, Bristol-Myers-Squibb, Merck KGaA, Novartis, Roche and Sanofi-Genzyme. His MS research is funded by the Swedish Research Council and the Swedish Brain foundation. TO has received advisory board and/or lecture honoraria, and unrestricted MS research grants from Biogen, Novartis, Sanofi, Merck and Roche. EF is partly funded by research grants from Biogen, and has received an unrestricted MS research grant from Celgene/Bristol Myers Squibb.

Figures

Figure 1.
Figure 1.
Cumulative percentage of the study cohort receiving their 1st DMT, by months since diagnosis.
Figure 2.
Figure 2.
(a, b) COI progression (estimated mean from the regressions) from baseline (index year) to the end of follow-up, by early vs. late treatment groups, adjusted for disability progression (mean annual EDSS score for each group) during the follow-up A) Healthcare costs. B) Productivity losses.
See this image and copyright information in PMC

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