Contributions
Abstract: P397
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Economic burden
Background: A chronic disease like multiple sclerosis (MS) involves not only suffering but also different healthcare and social security costs. Sweden has the 2nd highest MS prevalence in Europe, 189 cases/100,000 individuals. Still, most current studies on MS' cost of illness (COI) are based on small, highly selected, survey data. Larger, population-based studies are warranted, focusing on people with MS (PwMS) diagnosed after the introduction of new treatments. In addition, information on trajectories of healthcare, sickness absence (SA) and disability pension (DP) costs, over time, is scarce.
Aim: To explore the healthcare, SA, and DP cost trajectories among PwMS in Sweden over time, among newly diagnosed PwMS, linking the progression of costs with years since MS diagnosis.
Methods: All people living in Sweden, aged 25-60 years at MS diagnosis according to the National Patient Register, were included. Four different cohorts, based on year of MS diagnosis (2006-2009) were followed in nationwide registers prospectively for 5 years, up until 2013, determining 1) direct costs: healthcare utilization and out-of-pocket expenditure (in- and outpatient care), prescribed drugs, and 2) indirect costs: SA and DP. Average per patient costs were calculated in 2017 Swedish Krona (SEK). Descriptive statistics and group-based COI trajectories, stratified by year of MS diagnosis, were computed.
Results: 3272 new PwMS were identified. In all four cohorts, the majority had at least one inpatient stay and one outpatient visit during the follow-up (71% and 99%, respectively). Direct costs increased the 1st year after MS diagnosis; drug costs declined from 2 years after diagnosis and onwards (e.g. for the 2006 cohort, from SEK 35,191 to 60,737 one year after, to SEK 48,861 4 years after). Inpatient and outpatient costs increased again 2 years after diagnosis. While SA costs decreased over time (e.g. from SEK 14,970 to 4036, in the 2006 cohort), DP costs increased, indicating a shift, as disease progressed, from short-term to long-term social security benefits. Overall, direct costs were higher with each 1st year of MS diagnosis, while indirect costs were lower. Results were similar for both women and men in all four cohorts.
Conclusions: A decrease in total costs was observed 5 years after diagnosis; among other explanations, early MS diagnosis, allowing for early treatment, as well as new MS therapies, could lead to slowing disease progression, reducing costs over time.
Disclosure: All authors (KK, HG, FY, CM, EF, JH, and KA) are employees, or are affiliated, with the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, and have received funding from an unrestricted grant from Biogen to conduct this study. FY is currently employed by PAREXEL, HG is currently employed part-time by Statfinn & EPID Research, and KK has been employed by Quantify Research AB from October 2015 to February 2018; all three companies are contract research organisations that perform commissioned pharmacoepidemiological studies, and therefore are collaborating with several pharmaceutical companies.
Abstract: P397
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Economic burden
Background: A chronic disease like multiple sclerosis (MS) involves not only suffering but also different healthcare and social security costs. Sweden has the 2nd highest MS prevalence in Europe, 189 cases/100,000 individuals. Still, most current studies on MS' cost of illness (COI) are based on small, highly selected, survey data. Larger, population-based studies are warranted, focusing on people with MS (PwMS) diagnosed after the introduction of new treatments. In addition, information on trajectories of healthcare, sickness absence (SA) and disability pension (DP) costs, over time, is scarce.
Aim: To explore the healthcare, SA, and DP cost trajectories among PwMS in Sweden over time, among newly diagnosed PwMS, linking the progression of costs with years since MS diagnosis.
Methods: All people living in Sweden, aged 25-60 years at MS diagnosis according to the National Patient Register, were included. Four different cohorts, based on year of MS diagnosis (2006-2009) were followed in nationwide registers prospectively for 5 years, up until 2013, determining 1) direct costs: healthcare utilization and out-of-pocket expenditure (in- and outpatient care), prescribed drugs, and 2) indirect costs: SA and DP. Average per patient costs were calculated in 2017 Swedish Krona (SEK). Descriptive statistics and group-based COI trajectories, stratified by year of MS diagnosis, were computed.
Results: 3272 new PwMS were identified. In all four cohorts, the majority had at least one inpatient stay and one outpatient visit during the follow-up (71% and 99%, respectively). Direct costs increased the 1st year after MS diagnosis; drug costs declined from 2 years after diagnosis and onwards (e.g. for the 2006 cohort, from SEK 35,191 to 60,737 one year after, to SEK 48,861 4 years after). Inpatient and outpatient costs increased again 2 years after diagnosis. While SA costs decreased over time (e.g. from SEK 14,970 to 4036, in the 2006 cohort), DP costs increased, indicating a shift, as disease progressed, from short-term to long-term social security benefits. Overall, direct costs were higher with each 1st year of MS diagnosis, while indirect costs were lower. Results were similar for both women and men in all four cohorts.
Conclusions: A decrease in total costs was observed 5 years after diagnosis; among other explanations, early MS diagnosis, allowing for early treatment, as well as new MS therapies, could lead to slowing disease progression, reducing costs over time.
Disclosure: All authors (KK, HG, FY, CM, EF, JH, and KA) are employees, or are affiliated, with the Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden, and have received funding from an unrestricted grant from Biogen to conduct this study. FY is currently employed by PAREXEL, HG is currently employed part-time by Statfinn & EPID Research, and KK has been employed by Quantify Research AB from October 2015 to February 2018; all three companies are contract research organisations that perform commissioned pharmacoepidemiological studies, and therefore are collaborating with several pharmaceutical companies.