Increasing Disability in MS Matched by Rising Financial, Personal and Work-related Burdens

Multiple sclerosis (MS) patients in the U.S. with higher disability scores also have higher rates of health resource utilization, higher healthcare costs, and lower work productivity and health-related quality of live, according a study by researchers at Adelphi Real World and Abbvie.

The study, “Quantifying the relationship between increased disability and health care resource utilization, quality of life, work productivity, health care costs in patients with multiple sclerosis in the US,” was published in the journal BMC Health Services Research.

During the course of their disease, the majority of MS patients eventually experience some degree of functional impairment, which can affect not only their ability to live independently, but also their ability to work. Such impairments severely effect a patient’s psychosocial health and financial well-being, with dramatic changes in health-related quality of live.

Several studies have reported that increased disability in MS is associated with increased costs due to missed work days or unemployment on the one hand, and to growing needs for home modifications and mobility aids on the other, or a skilled nursing facility when disability becomes quite severe. However, most of these studies involved pre-2010 data, and new ones are required to address the current financial burden of MS.

The researchers conducted a real-world survey to explore the burden associated with MS disability in the U.S. In particular, they aimed to quantify the relationship between increased disability and healthcare resource utilization, healthcare costs, quality of life, ability to work, and productivity at work.

They included 715 patients (with a mean age of 42.1 and mean time since diagnosis of 6.9 years) whose neurologists completed a detailed patient report form. Among the patients, 355 completed a questionnaire reporting their perceptions of their diagnosis and quality of life.

Results revealed that patients with higher disability scores — higher than 3 as measured by the Expanded Disability Status Score (EDSS) — and current relapse had significantly higher utilization of health resources, including physician visits and hospitalizations in the 12 months that preceded the questionnaires, than those with EDSS lower than 3 and no current relapses.

In addition, patients with higher disability were significantly more likely to be unemployed, to have had to stop working, and exhibited poorer health-related quality of life.

The researchers also found that the healthcare costs related with hospitalizations, physician consultations, and therapy increased with disability status. In fact, patients with EDSS lower than 3 had total healthcare costs of $51,825 per year, whereas total annual care costs for patients with EDSS between 3 and 5 were $57,889, and $67,116 for those with EDSS higher than 5. Patients who experienced relapses in the last 12 months also spent more on healthcare ($58,648) than those without relapses ($51,692).

“Our research highlights the need for treatments targeted at slowing down or improving the physical disabilities associated with MS to improve patient work capacity, HRQoL [quality of health and life], and patient ability to self-care as well as to mitigate increased health resource utilization and its associated costs,” the researchers concluded.