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The cost and quality of life of MS

Open Door - May 2007 page 3

In 2005, we invited you to take part in a study of the cost of MS to society, and the impact on quality of life for the individual. Thank you to the 2,708 people who responded.

The research, which has recently been published[1,2], involved data from nine countries across Europe and was the first of its kind since 1993.

MS type

Using the Expanded Disability Status Scale (EDSS), a standard measure of disability in MS, 80% of respondents scored between 0 (no disability) and 6.5 (the score at which people are probably starting to use a wheelchair some of the time). 29% reported a relapse in the previous three months.

Work

The UK had the lowest level of people with MS in the workforce. More than 80% of respondents were aged between 40 and 69 and yet only just over a quarter were currently employed, with only 5.5% working full time. Almost half of the respondents had taken early retirement, the large majority due to their MS.

Cost of MS

The average annual cost to society of an individual having MS in the UK was calculated at £30,263. More than a third of this was due to lost productivity from early retirement. Direct medical costs accounted for almost £7,000 and non-medical expenses, such as the costs of informal care by members of the family, were valued at an average of £13,000.

As might be expected, the cost rose from about £12,000 per year for those people with milder symptoms, up to £60,000 for those with more advanced and complex problems.

Pie chart showing the elements that add up to the cost of MS: early retirement - 36.7% informal care - 31.3% ambulatory care - 11.3% disease modifying drugs - 5.8% services - 5.7% investments - 3.6% inpatient care - 2.9% other prescriptions and drugs - 2.3% tests - 0.2% sick leave - 0.1%

In the UK only 21% of respondents were using disease modifying drugs. Most other countries recorded levels of between 40% and 50%. Although drawing no conclusions, the researchers observed that the countries with the lowest proportion of people on disease modifying drugs (UK and the Netherlands) were also the two that reported the highest level of relapses in the preceding three months.

Quality of life

When comparing the quality of life (economists use the word utility) of people with a range of conditions, only rheumatoid arthritis scored lower than MS. A recent relapse, the length of time since diagnosis and, particularly, an increase in disability all led to lower quality of life scores.

Conclusion

What this study shows is that the effect of MS is not confined to clinical symptoms. The cost to society as a whole and the impact on the quality of life of the individual are substantial and should be taken into account when making economic evaluations of the condition and its treatments.

References

Kobelt G, et al.

Costs and quality of life of multiple sclerosis in the United Kingdom.
European Journal of Health Economics 2006;7:S96-S104.

Orme M, et al.

The effect of disease, functional status, and relapses on the utility of people with multiple sclerosis in the UK.
Value in Health 2007;10(1):54-60.

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