Can J Neurol Sci. 1998 Feb;25(1):23-30. doi: 10.1017/s0317167100033448.
Multiple sclerosis (MS) is a common neurologic disease in young and middle-aged adults affecting approximately 35,000 Canadians. The objectives of this study were to estimate the annual and lifetime costs of MS from the Canadian societal perspective.
Patients were consecutively recruited by neurologists in 14 MS outpatient clinics across Canada. They were classified according to the Expanded Disability Status Scale (EDSS) into three groups: mild (EDSS < or = 2.5), moderate (EDSS = 3.0-6.0) and severe (EDSS > or = 6.5). Sociodemographic, clinical and resource utilization data were collected retrospectively for the three months prior to patient inclusion. Costing of resources was performed from Ministry of Health, private third party payers, patient and societal perspectives. Average Canadian costs ($CDN 1995) were valued from available provincial data.
A total of 198 patients were included in the analysis (mild: n = 62, moderate: n = 68 and severe: n = 68). Costs increased with increasing EDSS scores, from all perspectives. The annualized societal costs per patient were $CDN14,523, $CDN21,698 and $CDN37,024 for the mild, moderate and severe groups, respectively. In all severity groups, most of the financial burden is borne by patients, from 74% to 88%. Indirect costs, namely lost daily activity/leisure time and lost productivity, were the major societal cost drivers. The lifetime cost of MS, including patient institutionalization, was estimated to be $CDN1,608,000 per patient.
In Canada, MS is associated with enormous direct and indirect costs. Patients carry most of the economic burden of this disease. The results of this burden of illness study provide a basis for cost-effectiveness analyses of new therapeutic interventions for MS.
多发性硬化症（MS）是一种常见于中青年的神经系统疾病，影响着约35000名加拿大人。本研究的目的是从加拿大社会角度估算MS的年度和终身成本。
加拿大14家MS门诊诊所的神经科医生连续招募患者。根据扩展残疾状态量表（EDSS）将他们分为三组：轻度（EDSS≤2.5）、中度（EDSS = 3.0 - 6.0）和重度（EDSS≥6.5）。回顾性收集患者入组前三个月的社会人口统计学、临床和资源利用数据。从卫生部、私人第三方支付者、患者和社会角度对资源进行成本核算。根据可用的省级数据估算加拿大的平均成本（1995年加元）。
共有198名患者纳入分析（轻度：n = 62，中度：n = 68，重度：n = 68）。从所有角度来看，成本随着EDSS评分的增加而增加。轻度、中度和重度组患者的年化社会成本分别为14523加元、21698加元和37024加元。在所有严重程度组中，大部分经济负担由患者承担，比例从74%到88%不等。间接成本，即日常活动/休闲时间损失和生产力损失，是主要的社会成本驱动因素。MS的终身成本，包括患者住院治疗，估计为每位患者1608000加元。
在加拿大，MS与巨大的直接和间接成本相关。患者承担了这种疾病的大部分经济负担。这项疾病负担研究的结果为MS新治疗干预措施的成本效益分析提供了依据。
