Social value of a set of proposals for the ideal approach of multiple sclerosis within the Spanish National Health System: a social return on investment study

Ester Moral Torres,Elvira Estella Pérez,Óscar Fernández Fernández,Teresa Gómez-García,Elena Ruiz-Beato,Pedro Carrascal Rueda,Álvaro Hidalgo-Vega,Margarita Jiménez,Rita Manzanares Estrada,María Merino

doi:10.1186/s12913-020-4946-8

Ester Moral Torres, Elvira Estella Pérez + Show 8 more

Open Access

https://doi.org/10.1186/s12913-020-4946-8

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Abstract

BackgroundMultiple Sclerosis (MS) is a chronic inflammatory, demyelinating and neurodegenerative disease that in many cases produces disability, having a high impact in patients’ lives, reducing significantly their quality of life. The aim of this study was to agree on a set of proposals to improve the current management of MS within the Spanish National Health System (SNHS) and apply the Social Return on Investment (SROI) method to measure the potential social impact these proposals would create.MethodsA Multidisciplinary Working Team of nine experts, with representation from the main stakeholders regarding MS, was set up to agree on a set of proposals to improve the management of MS. A forecast SROI analysis was carried out, with a one-year timeframe. Data sources included an expert consultation, a narrative literature review and a survey to 532 MS patients. We estimated the required investment of a hypothetical implementation, as well as the potential social value that it could create. We calculated outcomes in monetary units and we measured intangible outcomes through financial proxies.ResultsThe proposed ideal approach revealed that there are still unmet needs related to MS that can be addressed within the SNHS. Investment would amount to 148 million € and social return to 272 million €, so each euro invested could yield almost €2 of social return.ConclusionsThis study could guide health interventions, resulting in money savings for the SNHS and increases in patients’ quality of life.

Highlights

Multiple Sclerosis (MS) is a chronic inflammatory, demyelinating and neurodegenerative disease that in many cases produces disability, having a high impact in patients’ lives, reducing significantly their quality of life
Consensus for an ideal approach to MS A total of 18 proposals were obtained to contribute to an ideal approach to MS within the Spanish National Health System (SNHS) (Table 2)
The proposals of the area of the progressive forms of MS would help avoid unnecessary neurology department visits, improve labour protection linked to MS, reduce outbreaks and costs per patient thanks to early treatment, and improve the quality of life, motor status, fatigue, family relationships, and the emotional state of patients

Summary

Introduction

Multiple Sclerosis (MS) is a chronic inflammatory, demyelinating and neurodegenerative disease that in many cases produces disability, having a high impact in patients’ lives, reducing significantly their quality of life. Multiple sclerosis (MS) is the most disabling neurological disease in young adults, which causes significant limitations in patients’ personal, family, social, and work life [1,2,3]. As with other chronic diseases, patients with MS have a high incidence of co-morbidities [9, 10], that can affect the illness by delaying diagnosis, accelerating disability, worsening quality of life, and increasing mortality [11,12,13,14]. 45% of patients with MS of working age were employed or self-employed and, among those employed, 72% felt that MS affected their productivity, mainly due to fatigue (64%), difficulty thinking (29%), moodiness (27%), mobility (25%), and pain (20%) [18]

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