McCrone Paul, Heslin Margaret, Knapp Martin, Bull Paul, Thompson Alan
Institute of Psychiatry, King's College London, London, UK.
Pharmacoeconomics. 2008;26(10):847-60. doi: 10.2165/00019053-200826100-00005.
Multiple sclerosis (MS) is a chronic condition that affects quality of life (QOL), leads to disability and requires ongoing care inputs. Few studies have examined the impact of QOL, disability and demographic characteristics on treatment costs.
To investigate the links between service use, costs, QOL and disability for people with MS.
A cross-sectional study was conducted in people with MS who were members of the Multiple Sclerosis Society of Great Britain and Northern Ireland. A questionnaire, consisting of sociodemographic questions, the Client Service Receipt Inventory, EQ-5D and Guy's Neurological Disability Scale (GNDS), was sent to 4000 members of the Society. Service and lost employment costs were calculated. Regression models were developed to identify the participant characteristics that were associated with costs, QOL and disability. All costs are presented in year 2006-7 values.
Questionnaires were returned by 1942 members (48.9%). The mean (SD) EQ-5D QOL score was 0.41 (0.34), whilst the GNDS disability score was 20.8 (8.9). The mean (SD) service cost over the preceding 6 months was pound8397 ( pound10,404), and most of this (71.6%) was due to informal care. Only a small amount of cost (8.1%) was due to the use of disease-modifying drugs and drugs for spasticity. Lost employment costs amounted to a mean of pound4240. Higher costs were associated with higher levels of disability and lower levels of health-related QOL.
This study showed that MS participants had high levels of service use, and that QOL was low in comparison with other conditions. There were significant associations between costs, QOL and disability.
多发性硬化症（MS）是一种慢性疾病，会影响生活质量（QOL），导致残疾，并需要持续的护理投入。很少有研究探讨生活质量、残疾和人口统计学特征对治疗成本的影响。
调查MS患者的服务使用、成本、生活质量和残疾之间的联系。
对英国和北爱尔兰多发性硬化症协会成员中的MS患者进行了一项横断面研究。向该协会的4000名成员发送了一份问卷，其中包括社会人口学问题、客户服务收据清单、EQ-5D和盖伊神经残疾量表（GNDS）。计算了服务和失业成本。建立了回归模型，以确定与成本、生活质量和残疾相关的参与者特征。所有成本均以2006 - 2007年的价值呈现。
1942名成员（48.9%）回复了问卷。EQ-5D生活质量评分的平均值（标准差）为0.41（0.34），而GNDS残疾评分为20.8（8.9）。前6个月的平均（标准差）服务成本为8397英镑（10404英镑），其中大部分（71.6%）是由于非正式护理。只有少量成本（8.1%）是由于使用疾病修饰药物和抗痉挛药物。失业成本平均为4240英镑。成本越高与残疾程度越高和与健康相关的生活质量越低相关。
本研究表明，MS患者的服务使用水平较高，与其他疾病相比生活质量较低。成本、生活质量和残疾之间存在显著关联。
