Abstract
BackgroundEconomic costs related to treatment of multiple sclerosis (MS) must be justified by health state, quality of life (QOL) and social participation improvement. This study aims to describe correlations between social participation, economic costs, utility and MS-specific QOL in a sample of patients with MS (pwMS).MethodsWe interviewed 42 pwMS receiving natalizumab and collected clinical data, direct medical costs, productivity loss, utility (EQ5D-VAS), MS-specific QOL (SEP-59), social participation with the Impact on Participation and Autonomy questionnaire (IPA). We performed descriptive and correlation analyses.Results41 pwMS, with a mean Expanded Disability Status Scale (EDSS) score of 4.0, completed questionnaires. Mean annual global cost per patient was 68448 +/-33374 Euros and increased with EDSS (r = 0.644), utility (r = -0.456) and IPA (r = 0.519-0.671) worsening. Mean utility was 0.52 +/- 0.28. Correlations between IPA and QOL (EQ5D-VAS or SEP-59) were observed (r = -0.53 to -0.78). Association between QOL and EDSS was smaller (EQ5D-VAS) or absent. Productivity losses were poorly correlated to EDSS (r = 0.375).ConclusionModerate to strong correlations of social participation with clinical status (EDSS), QOL, utility and economic costs encourage exploring better these links in larger cohorts. The stronger correlation between social participation and QOL than between EDSS and QOL needs to be confirmed.
Highlights
Economic costs related to treatment of multiple sclerosis (MS) must be justified by health state, quality of life (QOL) and social participation improvement
We examined correlations between usual tools, as Expanded Disability Status Scale (EDSS), MS-specific or generic QOL scales, and the “impact on participation and autonomy questionnaire” (IPA)
This preliminary study was a part of a larger study that was approved by the local ethic committee named “Comité de Protection des Personnes Nord Ouest IV”
Summary
Economic costs related to treatment of multiple sclerosis (MS) must be justified by health state, quality of life (QOL) and social participation improvement. This study aims to describe correlations between social participation, economic costs, utility and MS-specific QOL in a sample of patients with MS (pwMS). For over 15 years, clinical trials of various subcutaneously or intramuscularly immunomodulatory drugs have demonstrated a modest reduction in relapse rate and limited effects on disability progression, with a well-known long-term safety but a poor daily tolerability [1]. In the current economic context with limited resources, national or international institutions need up-to-date economic burden studies and recommend assessment of patient-reported outcomes (PRO) as utilities in clinical trials [12,13]. Patient’s working capacity is well evaluated with loss of production in global burden studies, but others social disadvantages are only approached with utility scales
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