Increased socioeconomic burden in patients with primary progressive multiple sclerosis: A Danish nationwide population-based study.
Health costs
Multiple Sclerosis
Population-based
Progressive Multiple Sclerosis
Socioeconomic
Journal
Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247
Informations de publication
Date de publication:
Nov 2020
Nov 2020
Historique:
received:
01
05
2020
revised:
02
10
2020
accepted:
05
10
2020
pubmed:
11
12
2020
medline:
15
5
2021
entrez:
10
12
2020
Statut:
ppublish
Résumé
Primary progressive multiple sclerosis (PPMS) is characterized by development of more chronic neurological manifestations from disease onset compared with relapsing remitting MS (RRMS) and secondary progressive MS (SPMS) but the following socioeconomic consequences have never been described in a nation-wide patient population. To determine if socioeconomic burden of PPMS is increased compared with RRMS and SPMS. We included patients from The Danish Multiple Sclerosis Registry diagnosed between 1998 and 2015. Yearly average health costs, public transfers and earned income was calculated from the index diagnosis date, and each year in a five-year period before and after index diagnosis date, for the three patient groups. A regression model estimating the odds ratio (OR) with PPMS as the comparator, was used to analyze the differences between PPMS vs. RRMS and PPMS vs. SPMS controlling for age and sex. In total, 9563 MS patients were identified (1998-2015), with a characteristic distribution between different disease courses: 7012 patients with RRMS (73%), 1099 patients with PPMS (11%) and 1452 patients with SPMS (15%). Total health costs were lower in RRMS vs. PPMS (OR 0.76; 95% CI 0.74-0.78; p<0.0001) but not in SPMS vs. PPMS (OR 1.06; 95% CI 1.03-1.09; p<0.0001). Especially homecare costs were lower in RRMS vs. PPMS (OR 0.17; 95% CI 0.17-0.18; p<0.0001), less pronounced in SPMS vs. PPMS (OR 0.93; 95% CI 0.90-0.97; p = 0.0001). OR for health costs before and after diagnosis was significantly lower in RRMS vs. PPMS regarding most variables, less pronounced in SPMS vs. PPMS. This nation-wide population-based study show that socioeconomic burden is significantly higher in PPMS relative to RRMS, but less pronounced compared with SPMS.
Sections du résumé
BACKGROUND
BACKGROUND
Primary progressive multiple sclerosis (PPMS) is characterized by development of more chronic neurological manifestations from disease onset compared with relapsing remitting MS (RRMS) and secondary progressive MS (SPMS) but the following socioeconomic consequences have never been described in a nation-wide patient population.
OBJECTIVE
OBJECTIVE
To determine if socioeconomic burden of PPMS is increased compared with RRMS and SPMS.
METHODS
METHODS
We included patients from The Danish Multiple Sclerosis Registry diagnosed between 1998 and 2015. Yearly average health costs, public transfers and earned income was calculated from the index diagnosis date, and each year in a five-year period before and after index diagnosis date, for the three patient groups. A regression model estimating the odds ratio (OR) with PPMS as the comparator, was used to analyze the differences between PPMS vs. RRMS and PPMS vs. SPMS controlling for age and sex.
RESULTS
RESULTS
In total, 9563 MS patients were identified (1998-2015), with a characteristic distribution between different disease courses: 7012 patients with RRMS (73%), 1099 patients with PPMS (11%) and 1452 patients with SPMS (15%). Total health costs were lower in RRMS vs. PPMS (OR 0.76; 95% CI 0.74-0.78; p<0.0001) but not in SPMS vs. PPMS (OR 1.06; 95% CI 1.03-1.09; p<0.0001). Especially homecare costs were lower in RRMS vs. PPMS (OR 0.17; 95% CI 0.17-0.18; p<0.0001), less pronounced in SPMS vs. PPMS (OR 0.93; 95% CI 0.90-0.97; p = 0.0001). OR for health costs before and after diagnosis was significantly lower in RRMS vs. PPMS regarding most variables, less pronounced in SPMS vs. PPMS.
CONCLUSION
CONCLUSIONS
This nation-wide population-based study show that socioeconomic burden is significantly higher in PPMS relative to RRMS, but less pronounced compared with SPMS.
Identifiants
pubmed: 33296969
pii: S2211-0348(20)30641-6
doi: 10.1016/j.msard.2020.102567
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
102567Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.