PND13 SYSTEMATIC REVIEW OF THE COST OF ILLNESS OF MULTIPLE SCLEROSIS

Abstract

Multiple Sclerosis (MS) generates high degrees of disability in patients. Providing health care for this persons implies elevated costs for health systems and families through out of pocket expenses. The objective of this review is to identify the latest estimations of cost of illness in MS, focusing on the methodological approaches to identify, measure an valuate cost generating events and the types of costs estimated. A search strategy was developed with indexed terms for MS, cost analysis studies and disability, conducted from 2014 to 2018 in the EMBASE, PubMed and EconLit databases and complemented by handsearching and cross-referencing. Data pertaining to setting, population, cost analysis methodology and overall results was extracted from selected studies. 459 reports were identified, and 32 studies included. 25 (78,12%) were made in Europe, 4 (12,5%) in Latin America, one (3,12%) in Asia, and 1 (3,12%) in western Asia and The Middle East each. 1 study provided results on direct, indirect and intangible costs, 2 reported direct costs and 29 reported direct and indirect costs. Studies on direct costs took a health-care perspective, but one also included the patient perspective. All the other studies had a societal perspective. 4 studies had a top-down approach, the rest used a bottom-up approach. All studies valued productivity loses through human capital technique. Several studies reported costs based on EDSS scores. MS poses great burden on all societies, with varying resource utilization according to population, disease and health system characteristics. In the last five years European countries updated their data on MS, agreeing on the need to differentiate costs by disability status. These findings are consistent to those from Latin America and Asia regions. Methods for the estimation of economic impact of MS must consider ways to identify resource allocation and productivity losses by disability status.