Neuroscience Consultants; Comprehensive Multiple Sclerosis Center in affiliation with the National Multiple Sclerosis Center, and Baptist Health Doctors Hospital Multiple Sclerosis Center, Coral Gables.
Am J Manag Care. 2011 May;17 Suppl 5 Improving:S139-45.
Multiple sclerosis (MS) affects approximately 400,000 people in the United States and 2.1 million people worldwide. It is the most common chronic, non-traumatic neurological disorder afflicting young people during their peak productive ages. MS can diminish quality of life (QOL) by interfering with the ability to work, pursue leisure activities, and carry on usual life roles. Symptoms that affect QOL may include impaired mobility, fatigue, depression, pain, spasticity, cognitive impairment, sexual dysfunction, bowel and bladder dysfunction, vision and hearing problems, seizures, and sDwallowing and breathing difficulties. Direct medical costs of MS in the United States are estimated in excess of $10 billion per year. Indirect costs of MS include costs of reduced employment or unemployment, assistive equipment, disability related home modifications, and paid and unpaid personal care. Although direct medical costs predominate in the earlier stages of MS, indirect costs of productivity loss are responsible for higher costs later. Disease-modifying therapies (DMTs) lessen symptoms, reduce relapses, and delay disability progression. Unfortunately, many DMTs might produce only modest improvements in QOL. Although symptom-specific therapies do not delay disease progression, they may delay unemployment and dependency, thereby reducing indirect costs.
多发性硬化症（MS）在美国影响约 40 万人，在全球影响 210 万人。它是最常见的慢性、非创伤性神经障碍，影响年轻人在其生产高峰期的生活。MS 会降低生活质量（QOL），影响工作能力、追求休闲活动和履行日常角色的能力。影响 QOL 的症状可能包括行动不便、疲劳、抑郁、疼痛、痉挛、认知障碍、性功能障碍、肠和膀胱功能障碍、视力和听力问题、癫痫发作以及吞咽和呼吸困难。在美国，MS 的直接医疗费用估计每年超过 100 亿美元。MS 的间接成本包括就业减少或失业、辅助设备、与残疾相关的家庭改造、以及有偿和无偿的个人护理。尽管直接医疗费用在 MS 的早期阶段占主导地位，但生产力损失的间接成本在后期导致更高的费用。疾病修正疗法（DMT）可减轻症状、减少复发和延缓残疾进展。不幸的是，许多 DMT 可能只会对 QOL 产生适度的改善。虽然针对特定症状的治疗不会延迟疾病进展，但它们可能会延迟失业和依赖，从而降低间接成本。
