Rising Prevalence of Multiple Sclerosis in Switzerland: Results from the Swiss Multiple Sclerosis Registry

Abstract

Introduction: Understanding the prevalence of multiple sclerosis (MS) provides information for healthcare planning and helps identify trends and patterns of disease occurrence. For Switzerland, the number of persons with MS (pwMS) was last estimated at approximately 15,000 in 2016. The study's objectives were to update estimates of MS prevalence and characterise the change in MS prevalence in Switzerland between 2016 and 2021, the last year with complete administrative data.

Methods: The Swiss MS Registry (SMSR) is an ongoing, longitudinal study in Switzerland. It has previously established a methodology to assess the epidemiology of MS in Switzerland by integrating SMSR data with administrative data on reimbursement approvals for disease-modifying therapies (DMTs). Subsequently, the benchmark-multiplier method is applied to the combined data. Using the same methodology, we calculated overall and sex- and age-specific prevalence rates for 2021. Furthermore, we descriptively analysed changes since 2016 by comparing the prevalence figures and demographic and clinical characteristics of pwMS in both years.

Results: We estimated the population of pwMS in Switzerland at 18,140 (95% simulation interval: 17,550-18,750), corresponding to a period prevalence of 200.8-214.5/100,000 inhabitants. Peak prevalence was observed in the 50- to 55-year age group. Compared to 2016, the 2021 estimate corresponds to a 20% increase (n = 3,000). Extrapolating from Swiss population growth, we estimated that one-fifth of the observed prevalence increase may be attributed to a rising population. The proportion of pwMS in the age range from 50 to 64 (32.5% vs. 35.9%) and above 65 (8.0% vs. 11.1%) years increased. Consequently, the median (interquartile range) age increased from 47 (37-55) to 49 (38-57) years. The median age at diagnosis (36 [28-45] years) and the female-to-male ratio (2.7:1) remained stable since 2016. The proportion of pwMS treated with DMTs increased from 62.1% to 69.0%, with the largest change observed in infusion therapies (15.7% vs. 23.3%).

Conclusion: The estimated MS prevalence in Switzerland has increased since the previous estimate in 2016, with a shift in peak prevalence towards older ages. Population growth explained around one-fifth of this increase, thus leaving room for contributions by additional factors, which require further investigation. The rising MS prevalence has several implications for healthcare, research, and society.

Keywords: Epidemiology; Multiple sclerosis; Observational studies; Prevalence; Registries.

Fig. 1.

Description of data sources used to estimate MS prevalence and overview of the general estimation approach. The figures derived from the different data sources are not expected to add up directly but are rather incorporated into the estimation equation. MS, multiple sclerosis; DMT, disease-modifying therapy; pwMS, persons with multiple sclerosis.

Fig. 2.

Distribution of the absolute number of pwMS living in Switzerland in 2021. The median corresponds to 18,140, and the 95% simulation interval ranges from 17,550 to 18,750. The y-axis shows the percentage of the 100,000 simulations in a specific range based on the resampling approach.

Fig. 3.

Age- and sex-specific prevalence of MS in Switzerland per 100,000 population by year (2016 vs. 2021), shown in 5-year age strata. The transparent bands do not represent confidence intervals of the estimates but are a result of smoother functions; they visually indicate the expected variation of the data points around the estimated trend.