Karampampa Korinna, Gyllensten Hanna, Yang Fei, Murley Chantelle, Friberg Emilie, Hillert Jan, Alexanderson Kristina
Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.
Institute of Health and Care Science, University of Gothenburg, SE-405 30, Gothenburg, Sweden.
Pharmacoecon Open. 2020 Mar;4(1):91-103. doi: 10.1007/s41669-019-0150-3.
The aim was to longitudinally explore the healthcare, sickness absence (SA), and disability pension (DP) cost trajectories among newly diagnosed people with multiple sclerosis (MS), and investigate whether trajectories differ by year of MS diagnosis, sociodemographics, and multi-morbidity.
People with MS in Sweden, aged 25-60 years and with a new MS diagnosis in the years 2006, 2007, 2008, or 2009 (four different cohorts) were identified in nationwide registers and followed prospectively for 5 years, determining the annual, per patient, direct (inpatient and specialised outpatient healthcare, co-payments, and dispensed drugs) and indirect (SA and DP) costs. Descriptive statistics and group-based trajectories were computed.
In total, 3272 people with new MS were identified. In all cohorts, direct costs increased the year after diagnosis and thereafter declined (e.g. from €8261 to €9128, and to €7953, 5 years after diagnosis, for the 2006 cohort). SA costs continuously decreased over 5 years, while DP costs increased (e.g. from €9795 to €2778 vs. from €7277 to €15,989, respectively, for the 2006 cohort). When pooling all cohorts, four trajectories of direct and indirect costs were identified. A total of 32.1% of people with MS had high direct and indirect costs, which first increased and then decreased; the contrary was seen for trajectories with low direct and indirect costs.
There is heterogeneity in the development of MS costs over time after diagnosis; decreasing cost trajectories could be associated with the use of innovative MS therapies, slowing disease progression over time.
旨在纵向探究新诊断的多发性硬化症（MS）患者的医疗保健、病假缺勤（SA）和残疾抚恤金（DP）成本轨迹，并调查这些轨迹是否因MS诊断年份、社会人口统计学特征和多种疾病情况而有所不同。
在瑞典全国范围内的登记册中识别出年龄在25至60岁之间、于2006年、2007年、2008年或2009年（四个不同队列）首次诊断为MS的患者，并对其进行为期5年的前瞻性随访，确定每位患者每年的直接（住院和专科门诊医疗保健、自付费用以及配药）和间接（SA和DP）成本。计算描述性统计数据和基于组的轨迹。
总共识别出3272名新诊断为MS的患者。在所有队列中，直接成本在诊断后的第一年增加，此后下降（例如，2006年队列在诊断后5年，直接成本从8261欧元降至9128欧元，再降至7953欧元）。SA成本在5年内持续下降，而DP成本增加（例如，2006年队列分别从9795欧元增至2778欧元，以及从7277欧元增至15989欧元）。合并所有队列后，确定了直接和间接成本的四种轨迹。共有32.1%的MS患者具有高直接和间接成本，这些成本先增加后减少；而低直接和间接成本轨迹则相反。
MS诊断后成本随时间的发展存在异质性；成本下降轨迹可能与使用创新的MS疗法有关，随着时间推移疾病进展减缓。
