Chronic diseases like multiple sclerosis (MS) not only impact patients, they also inspire fear among healthy people who may be at risk of the disease. In a new study, researchers found that the availability of multiple sclerosis (MS) therapies provides “peace of mind” value to currently healthy individuals, particularly when the therapies are fully covered by insurance.
The study reporting the findings is titled “Reconsidering the Economic Value of Multiple Sclerosis Therapies” and was published in the American Journal of Managed Care.
MS is a demyelinating disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This damage disrupts the ability of parts of the nervous system to communicate, resulting in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems. There is no cure for MS, but treatments can help speed recovery from attacks, modify the course of the disease, and manage symptoms.
The costs of MS healthcare are supported primarily by healthy individuals without the disease. For example, premiums for private health insurance and taxes for public health insurance plans are paid by the entire population, not just those who have the disease.
The value of medical care to the sick is straightforward, but healthy individuals value medical technology because it will be available to them if they become sick in the future, providing peace of mind now.
“The real question in healthcare is whether members of society are getting what they pay for. Our study suggests that, from the perspective of the entire population, MS drugs are much more valuable than previously thought,” lead author Dr. Tiffany Shih, research economist at Precision Health Economics, said in a news release.
In the new study, researchers used economic theory models to illustrate the value to both sick and healthy people of three MS drugs, Avonex (interferon beta-1a), Tysabri (natalizumab), and Tecfidera (dimethyl fumarate), in two scenarios.
In the first scenario, the researchers assumed that those with MS would pay the full costs of the treatment, while in the second scenario, the researchers assumed that all individuals were covered under a fair health insurance plan.
In the first scenario, the researchers found that patients with MS gained $11.1 billion in value from the three therapies over the time of the study (2002-2013), while the value to healthy individuals was $8.9 billion, representing a combined consumer value of $20 billion. When health insurance was assumed to be available, however, the total value to sick and healthy grew to $46.2 billion.
The study’s results suggest that society benefits when costs are shared across the insurance pool, and value estimates that ignore the role of insurance may undervalue technology. Additionally, the authors found that the “peace of mind” value to the healthy is largest for severe diseases like MS.
“This paper brings tools of economic analysis to bear on the question of value in healthcare,” the authors wrote. “Our approach resolves 2 key omissions in prior valuations of MS therapies… First, this study quantified the role of insurance coverage in enhancing the value of therapy.
“Second, this study examined how MS therapies improve the outlook of those who face the risk of future MS onset, in addition to providing benefits to those who are already sick. We found that accounting for these two factors more accurately depicts the estimated overall value of the therapies considered here.”
“Theory predicts that treatments for severe disease provides ‘peace of mind’ value to the healthy. Avonex, Tysabri, and Tecfidera have generated significant social value, a large majority of which accrues to consumers. Future economic valuations of medical technology should consider both the potential value to the healthy and the effects of insurance,” the team concluded in their article.