Casado V, Romero L, Gubieras L, Alonso L, Moral E, Martinez-Yelamos S, Martinez-Yelamos A, Carmona O, Arbizu T
Multiple Sclerosis Unit, Institute of Biomedical Investigation, University Hospital of Bellvitge, Faculty of Medicine, Campus Bellvitge, University of Barcelona, Spain.
Mult Scler. 2007 Jul;13(6):800-4. doi: 10.1177/1352458506073480. Epub 2007 Mar 15.
Multiple sclerosis (MS) is a chronic demyelinating disease, which represents a great economic burden to society. Cost-of-illness studies of MS tend to underestimate the intangible costs related to pain, anxiety and helplessness. The purpose of this study was to estimate the intangible costs of MS, and determine whether these costs increase as disability progresses. We studied 211 consecutive patients with MS who attended our MS unit. Patients mean age was 41.6 (SD: 10.7) years, 69% were female, and their mean Expanded Disability Status Scale (EDSS) score was 2.47 (SD: 2.05). Quality-of-life was measured with the EuroQoL visual analogue scale. Quality-adjusted life year (QALY) was calculated for each patient. Patients were grouped into five disability stages according to their EDSS, and QALY was compared between patients and a group of healthy controls matched by age and sex. A benchmark value was ascribed to each QALY lost, and the intangible costs per patient-year were calculated as Euros 0 (EDSS =0), Euros 1100 (EDSS =1-3), Euros 8250 (EDSS =3.5-5.5), Euros 9900 (EDSS =6-7) and Euros 11,000 (EDSS >7.5). Sensitivity analysis showed a similar progression of costs. We conclude that intangible costs are relevant in MS, especially when disability increases. Although the method to calculate the costs remains controversial, we consider that they should be included in cost analysis of MS.
多发性硬化症（MS）是一种慢性脱髓鞘疾病，给社会带来了巨大的经济负担。MS的疾病成本研究往往低估了与疼痛、焦虑和无助相关的无形成本。本研究的目的是估计MS的无形成本，并确定这些成本是否随着残疾程度的进展而增加。我们研究了连续就诊于我们MS科室的211例患者。患者的平均年龄为41.6（标准差：10.7）岁，69%为女性，其平均扩展残疾状态量表（EDSS）评分为2.47（标准差：2.05）。采用欧洲生活质量视觉模拟量表测量生活质量。计算每位患者的质量调整生命年（QALY）。根据EDSS将患者分为五个残疾阶段，并将患者与按年龄和性别匹配的一组健康对照者的QALY进行比较。为每个损失的QALY赋予一个基准值，并计算每位患者每年的无形成本为0欧元（EDSS =0）、1100欧元（EDSS =1-3）、8250欧元（EDSS =3.5-5.5）、9900欧元（EDSS =6-7）和11000欧元（EDSS >7.5）。敏感性分析显示成本有类似的进展。我们得出结论，无形成本在MS中是相关的，尤其是当残疾程度增加时。尽管计算成本的方法仍存在争议，但我们认为它们应纳入MS的成本分析中。
