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Abstract Details

Direct Costs, Indirect Costs, and Quality of Life Burden of Multiple Sclerosis: National US Estimates
MS and Related Diseases
P03 - (-)
201
BACKGROUND: MS imposes significant but not well-quantified burden on patients, their families/caregivers, employers, and the healthcare system.
DESIGN/METHODS: We identified a sample of non-institutionalized patients aged ?18 with MS (ICD-9 code 340) using MEPS data (1998-2009) and compared them to individuals without MS during the interview year. Cohorts were compared on: healthcare utilization and their associated (direct) costs, indirect costs (including employment status and workdays missed), and HRQoL including quality-adjusted life years (QALYs). Due to measurement limitations of MEPS, we were not able to include all disease modifying therapy (DMT) utilization and related costs. Analyses were modeled using negative binomial, ordinary least squares, and logistic regression, adjusting for demographic and clinical characteristics.
RESULTS: Annual MS prevalence was estimated at 572,312 (95% CI: 397,004, 747,619). Annual direct medical expenditures were $11,065 higher for the MS versus non-MS (95% CI: $8,888, $13,242). Annual cost components higher for MS versus non-MS included: outpatient visits $3,443 (95% CI $2,442, $4,445), prescription (excluding DMT) costs $1,834 (95% CI $1,242, $2,427), and inpatient hospitalizations $1,546 (95% CI $39, $3,054). MS patients had a 3.3-fold (95% CI: 2.4, 4.5) increase in the odds of unemployment and a 4.4-fold higher number of days spent in bed (95% CI 2.97, 6.45) versus non-MS. Lifetime average QALYs lost were 10.04 for MS versus non-MS.
CONCLUSIONS: Findings confirm that MS patients have higher healthcare costs and utilization than their non-MS counterparts, and are at higher risk for unemployment and lower quality of life. Prevalence of MS is likely higher than previous conservative US estimates but may still be underestimated in this analysis due to the non-institutionalized study population.
Authors/Disclosures
Jonathan D. Campbell, PhD (ICER)
PRESENTER 		Dr. Campbell has received personal compensation for serving as an employee of Institute for Clinical and Economic Review.
Paul M. George, MD, PhD, MSE, FAAN (Stanford Hospital) Dr. George has received personal compensation in the range of $0-$499 for serving as a Consultant for ConductiveBio. Dr. George has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Law firms. The institution of Dr. George has received research support from Conductive Bio. The institution of Dr. George has received research support from NIH. Dr. George has received intellectual property interests from a discovery or technology relating to health care. Dr. George has received personal compensation in the range of $10,000-$49,999 for serving as a Adjudicator with Baim Insititute. Dr. George has a non-compensated relationship as a Board Member with 好色先生 that is relevant to AAN interests or activities. Dr. George has a non-compensated relationship as a International Stroke Council Program committee member with American Heart Association that is relevant to AAN interests or activities.
No disclosure on file
No disclosure on file
Sharon Cahoon-Metzger, PhD No disclosure on file
Terrie Livingston, PharmD (EMD Serono) Ms. Livingston has received personal compensation for serving as an employee of Octave Bioscience. Ms. Livingston has received personal compensation for serving as an employee of EMD Serono. Ms. Livingston has stock in Biogen. Ms. Livingston has stock in Octave Bioscience.
Timothy L. Vollmer, MD, FAAN The institution of Dr. Vollmer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen IDEC. The institution of Dr. Vollmer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech/Roche. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Siranax. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Meyers Squib. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Viela Bios. The institution of Dr. Vollmer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. The institution of Dr. Vollmer has received research support from Rocky Mountain MS Center. The institution of Dr. Vollmer has received research support from Biogen. The institution of Dr. Vollmer has received research support from Actelion. The institution of Dr. Vollmer has received research support from Genentech/Roche. The institution of Dr. Vollmer has received research support from Anokion. The institution of Dr. Vollmer has received research support from TG Therapeutics.
John Corboy, MD, FAAN (U of Colorado School of Medicine) Dr. Corboy has received personal compensation for serving as an employee of U of Coloado. Dr. Corboy has received personal compensation for serving as an employee of Rocky Mountain MS Center. Dr. Corboy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Mylan. Dr. Corboy has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squib. Dr. Corboy has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN. Dr. Corboy has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Neurological Association. Dr. Corboy has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Mylan. The institution of Dr. Corboy has received research support from MedDay. The institution of Dr. Corboy has received research support from Novartis. The institution of Dr. Corboy has received research support from NMSS. The institution of Dr. Corboy has received research support from PCORI. The institution of Dr. Corboy has received research support from EMD Serono.
Augusto A. Miravalle, MD, FAAN (Rush University) Dr. Miravalle has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Miravalle has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for EMD Serono. Dr. Miravalle has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Miravalle has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for TG. Dr. Miravalle has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Miravalle has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Miravalle has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for EMD Serono. Dr. Miravalle has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Miravalle has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for BMS. Dr. Miravalle has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for EMD Serono. Dr. Miravalle has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for TG therapeutics. Dr. Miravalle has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amgen. The institution of Dr. Miravalle has received research support from Genzyme. The institution of Dr. Miravalle has received research support from EMD Serono. The institution of Dr. Miravalle has received research support from Alexion.
Teri Schreiner, MD, MPH, FAAN (University of Colorado/ Children's Hospital of Colorado) The institution of Dr. Schreiner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CDC. Dr. Schreiner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. The institution of Dr. Schreiner has received research support from Roche Genentech.
No disclosure on file