Highlights
- •The paper provides a comprehensive analysis of the updated societal costs of Multiple Sclerosis (MS) in Australia.
- •Per person costs more than tripled from $30,561 (no disability) to $114,813 (severe disability).
- •Important differences exist between no disability and mild disability groups.
- •The current Australian MS landscape differs substantially from that in 2010.
- •Costs have shifted from lost wages to increased direct costs (of immunotherapies and others).
Abstract
Background
Economic costs of Multiple Sclerosis (MS) in Australia were last estimated in 2010
and are likely to have changed over time, especially given this new era of increased
access to higher efficacy disease modifying therapies (DMTs) with a strong focus on
earlier MS diagnosis and treatment.
Objectives
To provide a comprehensive contemporary analysis of the updated direct and indirect
costs of MS in Australia from a societal perspective and to examine how the cost landscape
has changed overtime.
Methods
Costs were estimated from the 2016 Economic Impact Survey (EIS) of the Australian
MS longitudinal Study (AMSLS) and were stratified by various (indirect and direct)
cost categories/sub-categories and disability severity. Disability was assessed with
the patient determined disease steps (PDDS) and mapped against the gold-standard Expanded
Disability Status Scale (EDSS), and classified as no disability (EDSS level: 0), mild
(EDSS 1–3.5), moderate (EDSS 4–6) and severe (EDSS 6.5–9.5). A generalized linear
model (GLM) predicted covariate adjusted costs for each disability severity. All costs
are presented in 2017 Australian dollars.
Results
488 (15.5% of the 3,163) AMSLS participants completed the survey. Annual costs per
person with MS increased 17% from 2010 to $68,382 in 2017, driven largely by increased
direct costs (from $16,306 in 2010 to $30,346 in 2017) (particularly those related
to DMTs, hospitalizations, consultations, and medical tests), but offset by decreased
costs of lost wages (from $29,030 in 2010 to $21,858 in 2017) as a result of recent
positive shifts in the employment landscape for Australians with MS. Costs increased
with increasing disability severity: $30,561 (95% confidence intervals [CI]: $25,672-$35,451),
$55,815 (95%CI: $47,503-$64,126), $76,915 (95%CI: $68,866-$84,964), and $114,813 (95%CI:
$102,252-$127,374) for no, mild, moderate and severe disability, respectively. The
differences in costs between the four disability groups remained statistically significant
even after adjustment for age, sex, DMT usage status, disease course and areas of
remoteness.
Conclusions
MS has an increasing economic burden in Australia. The study provides current economic
data on MS in Australia that are important for policy development, priority setting
and management of public health.
Keywords
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Article info
Publication history
Published online: June 03, 2020
Accepted:
May 27,
2020
Received in revised form:
May 8,
2020
Received:
January 30,
2020
Footnotes
Funding/Support: This study was supported by an unconditional grant provided to MS Research Australia by Merck Australia.
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
