Contributions
Abstract: P908
Type: Poster
Abstract Category: Clinical aspects of MS - Economic burden
Background: Multiple sclerosis (MS) often results in adults reducing or abandoning their workforce participation and relying heavily on support from the health care system, community and family.
Objectives: Within a European-wide burden of illness study, we assessed the impact of production losses, community and family support on total costs, and explored the factors that may affect their level of use.
Methods: Patients provided data on their disease, resource use, fatigue, cognition, work productivity and health related quality of life. Resources were valued from the societal perspective using publicly available unit costs. Production losses (sick leave, invalidity and early retirement) were valued using the human capital approach with gender specific employment cost. Informal care costs were calculated as the opportunity cost of time using disposable income. Factors affecting workforce participation were explored using logistic regression.
Results: 16,400 patients from 16 countries participated, covering all Expanded Disability Status Scale (EDSS) levels. Based on 13,844 patients from 10 countries, mean age was 52±12 years, with 80% of working age, mean disease duration 15±10 years and 74% were women. Production losses, community and family support accounted for 39-74% of total costs and were all directly related to disease severity. Depending on the country, employment rate was 52-78% in mild MS (EDSS < 3), 27-50% in moderate MS (EDSS 4-6.5) and 10-23% in severe MS (EDSS 7-9). 43% worked part-time and in 41% of these, it was due to MS. 79% of working patients reported difficulties at work due to MS, predominantly related to fatigue, concentration and mobility. Loss of work capacity, community support and informal care use were related to disease severity in all countries, but the level of service use differed considerably: community services were used by 2-16%, 9-39% and 17-69% and informal care by 17-34%, 52-74% and 62-93% of patients in mild, moderate and severe disease, respectively. Controlling for age, disease severity, gender and country, patients in the workforce used fewer services but had a higher use of disease modifying treatments (p>0.001).
Conclusion: MS affects workforce participation and the need for services at all disease levels, resulting in one of the major cost components in MS in all countries. Direct comparisons between countries can however not be made without taking into account sample differences and economic conditions.
Disclosure: The study is funded by Biogen Inc.
Gisela Kobelt: received consulting fees from Biogen, Genzyme/Sanofi, Merck Serono, Novartis, Roche and Teva
Jenny Berg: working for consultancy performing projects for pharmaceutical companies
Mia Gannedahl: working for consultancy performing projects for pharmaceutical companies
Jennifer Eriksson: working for consultancy performing projects for pharmaceutical companies
Alan Thompson: received honoraria/support for travel for consultancy from Eisai, Excemed, MedDay, support for travel from the International Progressive MS Alliance (chair, Scientific Steering Committee), from the National MS Society (USA) (member, Research Programs Advisory Committee), and an honorarium from SAGE Publishers (Editor-in-Chief for Multiple Sclerosis Journal)
Abstract: P908
Type: Poster
Abstract Category: Clinical aspects of MS - Economic burden
Background: Multiple sclerosis (MS) often results in adults reducing or abandoning their workforce participation and relying heavily on support from the health care system, community and family.
Objectives: Within a European-wide burden of illness study, we assessed the impact of production losses, community and family support on total costs, and explored the factors that may affect their level of use.
Methods: Patients provided data on their disease, resource use, fatigue, cognition, work productivity and health related quality of life. Resources were valued from the societal perspective using publicly available unit costs. Production losses (sick leave, invalidity and early retirement) were valued using the human capital approach with gender specific employment cost. Informal care costs were calculated as the opportunity cost of time using disposable income. Factors affecting workforce participation were explored using logistic regression.
Results: 16,400 patients from 16 countries participated, covering all Expanded Disability Status Scale (EDSS) levels. Based on 13,844 patients from 10 countries, mean age was 52±12 years, with 80% of working age, mean disease duration 15±10 years and 74% were women. Production losses, community and family support accounted for 39-74% of total costs and were all directly related to disease severity. Depending on the country, employment rate was 52-78% in mild MS (EDSS < 3), 27-50% in moderate MS (EDSS 4-6.5) and 10-23% in severe MS (EDSS 7-9). 43% worked part-time and in 41% of these, it was due to MS. 79% of working patients reported difficulties at work due to MS, predominantly related to fatigue, concentration and mobility. Loss of work capacity, community support and informal care use were related to disease severity in all countries, but the level of service use differed considerably: community services were used by 2-16%, 9-39% and 17-69% and informal care by 17-34%, 52-74% and 62-93% of patients in mild, moderate and severe disease, respectively. Controlling for age, disease severity, gender and country, patients in the workforce used fewer services but had a higher use of disease modifying treatments (p>0.001).
Conclusion: MS affects workforce participation and the need for services at all disease levels, resulting in one of the major cost components in MS in all countries. Direct comparisons between countries can however not be made without taking into account sample differences and economic conditions.
Disclosure: The study is funded by Biogen Inc.
Gisela Kobelt: received consulting fees from Biogen, Genzyme/Sanofi, Merck Serono, Novartis, Roche and Teva
Jenny Berg: working for consultancy performing projects for pharmaceutical companies
Mia Gannedahl: working for consultancy performing projects for pharmaceutical companies
Jennifer Eriksson: working for consultancy performing projects for pharmaceutical companies
Alan Thompson: received honoraria/support for travel for consultancy from Eisai, Excemed, MedDay, support for travel from the International Progressive MS Alliance (chair, Scientific Steering Committee), from the National MS Society (USA) (member, Research Programs Advisory Committee), and an honorarium from SAGE Publishers (Editor-in-Chief for Multiple Sclerosis Journal)