Department of Applied Economics, Public Economics and Political Economy, University Complutense of Madrid, Pl. Menéndez Pelayo 4, 28040, Madrid, Spain.
Graduate School of Health Economics and Management (Alta Scuola Di Economia E Management Dei Sistemi Sanitari), Universitá Cattolica del Sacro Cuore, Rome, Italy.
Eur J Health Econ. 2023 Mar;24(2):247-277. doi: 10.1007/s10198-022-01471-9. Epub 2022 May 20.
Multiple sclerosis imposes a heavy burden on the person who suffers from it and on the relatives, due to the caregiving load involved. The objective was to analyse whether the inclusion of social costs in economic evaluations of multiple sclerosis-related interventions changed results and/or conclusions.
A systematic review was launched using Medline and the Cost-Effectiveness Analysis Registry of Tufts University (2000-2019). Included studies should: (1) be an original study published in a scientific journal, (2) be an economic evaluation of any multiple sclerosis-related intervention, (3) include productivity losses and/or informal care costs (social costs), (4) be written in English, (5) use quality-adjusted life years as outcome, and (6) separate the results according to the perspective applied.
Twenty-nine articles were selected, resulting in 67 economic evaluation estimations. Social costs were included in 47% of the studies. Productivity losses were assessed in 90% of the estimations (the human capital approach was the most frequently used method), whereas informal care costs were included in nearly two-thirds of the estimations (applying the opportunity and the replacement-cost methods equally). The inclusion of social costs modified the figures for incremental costs in 15 estimations, leading to a change in the conclusions in 10 estimations, 6 of them changing from not recommended from the healthcare perspective to implemented from the societal perspective. The inclusion of social costs also altered the results from cost-effective to dominant in five additional estimations.
The inclusion of social costs affected the results/conclusions in multiple sclerosis-related interventions, helping to identify the most appropriate interventions for reducing its economic burden from a broader perspective.
多发性硬化症给患者及其家属带来了沉重的负担，因为这涉及到照顾的负担。本研究旨在分析在多发性硬化症相关干预措施的经济评估中纳入社会成本是否会改变结果和/或结论。
使用 Medline 和 Tufts 大学成本效益分析登记处（2000-2019 年）进行了系统综述。纳入的研究应：（1）为发表在科学期刊上的原始研究，（2）为任何多发性硬化症相关干预措施的经济评估，（3）包括生产力损失和/或非正式护理成本（社会成本），（4）用英文书写，（5）使用质量调整生命年来作为结果，（6）根据所应用的观点来分离结果。
共选择了 29 篇文章，得出了 67 项经济评估估计。47%的研究纳入了社会成本。90%的估计评估了生产力损失（最常用的方法是人力资本法），而近三分之二的估计纳入了非正式护理成本（同样采用机会和替代成本法）。纳入社会成本改变了 15 项增量成本估计的数字，导致 10 项估计的结论发生变化，其中 6 项从医疗保健角度不推荐改为从社会角度实施。纳入社会成本还使另外 5 项估计的结果从成本效益改为优势。
纳入社会成本会影响多发性硬化症相关干预措施的结果/结论，有助于从更广泛的角度确定最适合减轻其经济负担的干预措施。
