Ponzio Michela, Santoni Laura, Molina Michela, Tavazzi Eleonora, Bergamaschi Roberto
Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy.
Biogen Italia, Milan, Italy.
J Neurol. 2024 Dec 12;272(1):50. doi: 10.1007/s00415-024-12729-y.
In this observational cross-sectional study conducted in Italy, sociodemographic and disease data were collected from a multiple sclerosis (MS) population treated with disease-modifying therapies (DMTs). A prevalence-based cost-of-illness analysis was subsequently carried out. In total, 393 MS patients were enrolled, 65.9% female, average age of 45 ± 11.5 years. 94.9% had RRMS and EDSS median value of 1.5 (1.0, 2.0). The mean total cost per MS patient was estimated at €20,299.4 per year. Total costs of MS increase by disability level, varying from 16,812.0 (minor) to 20,407.0 (mild), 27,640.7 (moderate), and 44,404.0 (severe). DMT costs accounted for 62.5% of total costs, while productivity loss accounted for 22.0%. Indeed, besides having low quality of life decline and fatigue levels, most patients enrolled retained full working capacity while 31.3% had some productivity loss. The results obtained are in line with previous studies showing that as the disease progresses, the quality of life, fatigue and working capacity worsen alongside a rise in total MS costs for either the society or the healthcare service. Clinical relapses cause a significant cost increment. This cross-sectional study provides a representation of MS quality of life and MS cost in a cohort of Italian MS patients treated with DMT, among which the majority had RRMS. This cost-of-illness analysis can provide useful information for resource allocation and help estimate the savings that can be obtained by slowing the progression of the disease. It also constitutes a primary source of data useful for conducting a complete economic evaluation analysis, including cost-effectiveness and cost-utility analyses.
在这项于意大利开展的观察性横断面研究中,收集了接受疾病修正疗法(DMTs)治疗的多发性硬化症(MS)患者的社会人口统计学和疾病数据。随后进行了基于患病率的疾病成本分析。总共纳入了393例MS患者,其中65.9%为女性,平均年龄为45±11.5岁。94.9%的患者为复发缓解型多发性硬化症(RRMS),扩展残疾状态量表(EDSS)中位数为1.5(1.0,2.0)。估计每位MS患者每年的总费用为20,299.4欧元。MS的总成本随残疾程度增加而上升,从轻度的16,812.0欧元到中度的20,407.0欧元、重度的27,640.7欧元以及极重度的44,404.0欧元不等。DMT费用占总成本的62.5%,而生产力损失占22.0%。实际上,除了生活质量下降和疲劳程度较低外,大多数纳入的患者仍保留全部工作能力,而31.3%的患者有一定的生产力损失。所得结果与先前的研究一致,表明随着疾病进展,生活质量、疲劳和工作能力会恶化,同时社会或医疗服务的MS总成本会上升。临床复发会导致成本显著增加。这项横断面研究展示了接受DMT治疗的意大利MS患者队列中的MS生活质量和MS成本情况,其中大多数为RRMS患者。这项疾病成本分析可为资源分配提供有用信息,并有助于估计通过减缓疾病进展可实现的节省。它也是进行完整的经济评估分析(包括成本效益分析和成本效用分析)的重要数据来源。