Costs and quality of life in multiple sclerosis

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Abstract
Objective: To estimate current costs and quality of life (utility) of patients treated with disease modifying drugs (DMDs) in the United States, and to investigate the effect of disease severity on costs and utility. Methods: Data on demographics, disease information, resource utilization (including work capacity), and utility were collected directly from patients in a cross-sectional postal survey. Patients were selected randomly among participants in the North American Committee on Multiple Sclerosis Patient Registry (NARCOMS) receiving DMDs. Mean annual costs per patient (2004 USD) and mean utilities for the sample and for different levels of functional disability are estimated from the societal perspective. Results: The target answer rate of 50% was reached and 1,909 patients were included in the analysis. The mean age was 49 years and time since diagnosis was 13 years. A total of 10.5% of patients had primary progressive, 47.6% relapsing-remitting, and 33.3% secondary progressive disease. A total of 28.8% of patients indicated to have experienced a relapse during the past 3 months. Total average costs are estimated at $47,215 per patient and year. Of these, 53% were for direct medical and non-medical costs, 37% for production losses, and 10% for informal care. Mean utility in the sample was 0.698. Conclusions: Consistent with other studies, costs and utilities were significantly correlated with functional capacity. The proportion of costs represented by disease modifying drugs is considerably lower than estimated in other studies, as all costs related to the disease are included.