Costs of ‘COVID-19 gap’ in MS expected to top $500M in Canada

The overall financial impact of changes in treatment and delayed diagnoses for people with multiple sclerosis (MS) in Canada due to the COVID-19 pandemic likely will be in the hundreds of millions of dollars between 2020 and 2024 in terms of extra healthcare costs and lost productivity, as well as worsened well-being for patients.

That’s according to a new report by Deloitte Access Economics on the so-called COVID-19 gap in Canada as it relates to MS. The research report put the costs of reduced patient well-being due to pandemic-related disruptions in care by itself at more than $400 million (about $290 million). More than $100 million (about $73 million) was estimated for increased costs of healthcare and drops in productivity for patients.

Based on these findings, MS Canada is calling on the Canadian government to invest money into MS specialty care and research into ways to prevent or treat the neurodegenerative disease, in an attempt to close the pandemic gap.

“If we want to mitigate this impact to the MS community, governments can step up — and ultimately save themselves money — by doing these things: investing $15 million [about $11 million] immediately in prevention and treatment research building on the breakthrough discovery linking Epstein-Barr virus (EBV) to MS, and boosting MS specialist care by funding additional MS healthcare professionals — from MS nurses to neurologists,” Pamela Valentine, PhD, president and CEO of MS Canada, said in a press release from the organization.

“Australia has just announced $18 million in research funding to follow up on a breakthrough link between MS and Epstein-Barr virus (EBV), which could foreseeably lead to a preventative vaccine. Canada must do the same,” Valentine said.

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Living with MS carries a hefty price tag. In addition to the cost of care for medications and other types of medical care and support, MS can make it harder to consistently work a job, resulting in lost economic productivity. The disease also can reduce patients’ wellbeing, which in economic terms can be quantified as lost value.

In this report, the researchers first estimated the total cost of MS care in Canada in 2019, before the COVID-19 pandemic. That number was estimated to be $3.4 billion (about $2.5 billion), which based on the frequency of MS in Canada works out to $42,880 (about $32,000) per person. Direct costs related to healthcare and indirect costs related to lost productivity made up most of these costs in the models.

During the first years of the COVID-19 pandemic — from 2020 to 2022 — spending on MS-related healthcare decreased by a total of about $566 million (about $413 million) in Canada, in comparison with what would have been expected based on trends before the pandemic.

This decrease in spending is likely reflective of pandemic-related disruptions in MS care, such as patients not receiving appropriate treatment or not getting diagnosed in a timely manner, according to the researchers.

The impact of these pandemic-related disruptions in care, sometimes termed the COVID-19 gap, has worrying implications for the future, especially in terms of patient health. Available treatments for MS are able to slow the disease’s progression, but they cannot undo damage once it occurs. As such, people with MS who didn’t get adequate care as a result of the pandemic are likely going to experience more severe disability and need more intensive care in the future.

“Early diagnosis and timely intervention with the most effective treatment is key to protecting brain health, preserving function, and minimizing the impact on our healthcare system,” Valentine said.

“The COVID-19 gap has led to a health services backlog and unmet health needs for Canadians living with MS,” Valentine said, adding, “It has led to progression of MS in many Canadians, due to delayed or halted treatments — this will impact these individuals and their families’ quality of life and livelihood.”

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This is especially concerning, according to MS Canada, as the country has “one of the highest rates of MS in the world.” An average of 12 Canadians are diagnosed with MS daily, and more than 90,000 people in Canada are living with the disorder, per the nonprofit.

“Delays and changes to treatment can lead to irreversible disease progression and disability,” Valentine said.

“There is a saying that ‘time is brain’ — meaning delayed care means irreversibly worse outcomes for the patient,” she said, adding, “When nervous tissue is lost or damaged, it cannot be recovered. You can’t ‘catch up later’ with treatment.”

While the changes in the provision of health services reduced MS-related health expenditure between 2020 and 2022, evidence from this study suggests that these costs are now rising above the level that would have been expected in the absence of the pandemic to clear the backlog in health services.

From the economic models, the researchers estimated that pandemic-related disruptions will lead to about $578.2 million (about $425 million) in additional MS-related costs between 2020 and 2024. This included $138 million in increased healthcare costs and lost productivity, as well as more than $400 million in reduced wellbeing for patients.

“While the changes in the provision of health services reduced MS-related health expenditure between 2020 and 2022, evidence from this study suggests that these costs are now rising above the level that would have been expected in the absence of the pandemic to clear the backlog in health services,” the scientists wrote.

“Coupled with significant excess costs related to a worsening in the disease state of many people with MS due to treatment changes and delayed diagnoses, this trend towards higher costs is expected to continue – and rise – in future years,” they added.

The researchers called for further study to quantify the impact of COVID-19 in MS, and said the given estimates will need to be updated “as the longer-term outcomes from the pandemic are realised.”