Blozik Eva, Rapold Roland, Eichler Klaus, Reich Oliver
Department of Health Sciences, Helsana Group, Zürich, Switzerland.
Institute of General Practice, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Neuropsychiatr Dis Treat. 2017 Nov 1;13:2737-2745. doi: 10.2147/NDT.S143180. eCollection 2017.
Medical therapy for multiple sclerosis (MS) is expensive. Quantifying the burden of MS is fundamental for health-care planning and the allocation of resources for the management of MS. This study provides current national estimates of prevalence, incidence, mortality, and costs of MS in Switzerland using claims data between 2011 and 2015.
We analyzed health insurance claims of adult persons enrolled with a large health insurance group covering about 13% of the Swiss population between 2011 and 2015. The identification of patients with MS was based on prescription data of MS-specific medication using the Anatomical Therapeutic Chemical Classification system as proxy for clinical diagnosis. We estimated prevalence, mortality, and costs of basic health insurance between 2011 and 2015. Furthermore, incidence of MS was calculated for 2015. All results were weighted with census data to achieve an extrapolation to the Swiss general population level. Cost of illness was estimated as direct medical cost from the perspective of a Swiss health insurance using multivariate linear regression analysis.
Of the 943,639 subjects in the year 2015, 1,606 were identified as MS patients resulting in a prevalence of 190 per 100,000 (95% CI: 180-190 per 100,000). Incidence was 16 per 100,000 (95% CI: 13-19 per 100,000). According to regression analysis, the total cost of illness for basic mandatory health insurance was 26,710 Swiss Francs (CHF) (95% CI: 26,100-27,300) per person per year with the cost of medication being almost identical 26,960 CHF (95% CI: 26,170-27,800).
MS affects 10,000-15,000 persons in Switzerland, and the prevalence has increased over the last 22 years. These persons have high need and demand for health care. High costs are primarily due to expenses for medication. Given the imbalance of MS medication therapy from the perspective of basic health insurance on the disposable resources, it is crucial to increase transparency related to the volume, type, and allocation of expenses.
多发性硬化症（MS）的药物治疗费用高昂。量化MS的负担对于医疗保健规划和MS管理资源的分配至关重要。本研究利用2011年至2015年的索赔数据，提供了瑞士目前全国范围内MS的患病率、发病率、死亡率及成本的估计。
我们分析了2011年至2015年期间参加大型健康保险集团的成年人的健康保险索赔情况，该集团覆盖了约13%的瑞士人口。MS患者的识别基于使用解剖治疗化学分类系统作为临床诊断替代指标的MS特异性药物的处方数据。我们估计了2011年至2015年基本医疗保险的患病率、死亡率和成本。此外，计算了2015年MS的发病率。所有结果均根据人口普查数据进行加权，以推断至瑞士总人口水平。从瑞士健康保险的角度，使用多元线性回归分析将疾病成本估计为直接医疗成本。
在2015年的943,639名受试者中，1606人被确定为MS患者，患病率为每10万人190例（95%置信区间：每10万人180 - 190例）。发病率为每10万人16例（95%置信区间：每10万人13 - 19例）。根据回归分析，基本强制医疗保险的疾病总成本为每人每年26,710瑞士法郎（CHF）（95%置信区间：26,100 - 27,300 CHF），药物成本几乎相同，为26,960 CHF（95%置信区间：26,170 - 27,800 CHF）。
MS影响瑞士10,000 - 15,000人，且患病率在过去22年中有所上升。这些人对医疗保健有很高的需求。高成本主要归因于药物费用。从基本医疗保险可支配资源的角度来看，鉴于MS药物治疗的不平衡，提高费用的数量、类型和分配的透明度至关重要。
