Nondrug therapy costs high for MS patients in Austria, study finds
Dietary supplements, therapeutic interventions widely used
People with multiple sclerosis (MS) in Austria spend an average of €136 (about $149) per month on nondrug therapies such as dietary supplements and therapeutic interventions like physiotherapy, a study found.
These complementary and alternative medicines (CAMs) are generally not fully covered by Austria’s public healthcare system, leaving many patients responsible for out-of-pocket costs and co-pays for these types of care. Despite this, 82% of patients in the study reported using CAMs on a regular basis to help manage their MS symptoms.
Use of CAMs was more common among people with primary progressive MS (PPMS), who also spent significantly more on these therapies than those with relapsing-remitting MS (RRMS). According to the researchers, the high use of these therapies underscores patients’ “willingness to actively participate in their disease management,” and highlights the need for healthcare providers to offer evidence-based guidance.
The study, “Financial burden of out of pocket nonpharmacological therapies in an Austrian multiple sclerosis cohort,” was published in Scientific Reports.
While several disease-modifying therapies (DMTs) are approved to treat MS, these therapies cannot fully address symptoms or prevent them from worsening over time. As a result, patients often turn to dietary supplements and interventions such as physiotherapy and massage therapy to help manage their symptoms.
Nutritional supplements, dietitians, acupuncture
Although there is little scientific evidence that these treatment approaches are effective in MS, their use is higher in MS patients than in people with other chronic conditions such as high blood pressure or diabetes.
Though costs for these therapeutic interventions often fall directly on patients, little is known about how much these therapies are costing patients and contributing to economic constraints.
To find out, a team of researchers in Austria in May 2024 recruited 104 patients who had participated in a previous clinical trial. Patients were asked to fill out a questionnaire about their use of nutritional supplements, such as vitamins and natural remedies, and interventions administered by therapists.
Of the 104 patients, most were women (64%), and the mean age was 44. The majority had RRMS (79%), while 12% had secondary progressive MS (SPMS), and 10% had PPMS. Thirteen percent of patients were not receiving any DMT at the time of the analysis.
A total of 98 participants correctly completed the online survey. Of these, 82% said they used nondrug treatments on a regular basis, with use being generally comparable among disease types and sexes.
About 76% of patients reported taking oral supplements regularly, with more than 60 different supplements mentioned. Vitamin D was the most commonly used (by 43%), followed by magnesium (19%) and vitamin B (12%).
Fifty-one percent of patients reported using other therapeutic interventions regularly. The most common were physiotherapy and massage therapy, reported by 31% and 21% of respondents, respectively. Osteopathy, dietitian visits, acupuncture, homeopathy, and chiropractor use were among other interventions mentioned. About a quarter of patients visited two therapists regularly, and 14% visited three or more.
Although use of CAMs was similar across MS types, an analysis of dietary supplements and therapist interventions alone showed that both were more frequently used by people with PPMS (89% each) compared with RRMS (75% and 45%, respectively) and SPMS (73% and 64%).
PPMS patients also had higher monthly expenses with CAMs, paying an average of €337 for these therapies each month. SPMS patients’ monthly expenditures averaged €154 (or $170), while the lowest expenses were observed for those with RRMS (€110, or $122).
CAM expenses are particularly notable because study participants tended to have reduced income, averaging 26 hours of work per week, the researchers said.
Despite incurring in the highest monthly expenses, individuals with PPMS also tended to work the fewest, with an average of 11 hours per week.
“These individuals not only face higher costs but also reported fewer working hours per week, thereby exacerbating their financial strain,” the team wrote.
The heavy use of CAMs among individuals with MS suggests that people are eager to be active participants in their treatment plans, the researchers suggested. However, there may be a communication gap between clinicians and patients when it comes to CAMs, they said.
Physicians and patients may be hesitant to broach the topic of complementary therapies, due to lack of time during healthcare visits or patients’ reluctance to disclose their use of these therapies because of possible negative reactions from their healthcare providers, the researchers said.
“Therefore, it is crucial for physicians to foster open communication, providing accurate information about the efficacy and tolerability of CAMs based on scientifically valid data,” they wrote.
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