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Cost of Illness of Multiple Sclerosis: A Systematic Review
Department of Learning, Informatics, Management and Ethics, Karolinska Institutet; Department of Clinical Neuroscience, Karolinska Institutet.
Department of Clinical Neuroscience, Karolinska Institutet.
Department of Clinical Neuroscience, Karolinska Institutet.
Department of Clinical Neuroscience, Karolinska Institutet; The Swedish Red Cross University College.ORCID iD: 0000-0001-6138-6427
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2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 7, e0159129Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Cost-of-illness (COI) studies of Multiple Sclerosis (MS) are vital components for describing the economic burden of MS, and are frequently used in model studies of interventions of MS. We conducted a systematic review of studies estimating the COI of MS, to compare costs between studies and examine cost drivers, emphasizing generalizability and methodological choices.

MATERIAL AND METHOD: A literature search on studies published in English on COI of MS was performed in PubMed for the period January 1969 to January 2014, resulting in 1,326 publications. A mapping of studies using a bottom-up approach or top-down approach, respectively, was conducted for the 48 studies assessed as relevant. In a second analysis, the cost estimates were compared between the 29 studies that used a societal perspective on costs, human capital approach for indirect costs, presenting number of patients included, time-period studied, and year of price level used.

RESULTS: The mapping showed that bottom-up studies and prevalence approaches were most common. The cost ratios between different severity levels within studies were relatively stable, to the ratio of 1 to 2 to 3 for disability level categories. Drugs were the main cost drivers for MS-patients with low disease severity, representing 29% to 82% of all costs in this patient group, while the main cost components for groups with more advanced MS symptoms were production losses due to MS and informal care, together representing 17% to 67% of costs in those groups.

CONCLUSION: The bottom-up method and prevalence approach dominated in studies of COI of MS. Our findings show that there are difficulties in comparing absolute costs across studies, nevertheless, the relative costs expressed as cost ratios, comparing different severity levels, showed higher resemblance. Costs of drugs were main cost drivers for less severe MS and informal care and production losses for the most severe MS.

Place, publisher, year, edition, pages
2016. Vol. 11, no 7, e0159129
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
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URN: urn:nbn:se:rkh:diva-2269DOI: 10.1371/journal.pone.0159129PubMedID: 27411042OAI: oai:DiVA.org:rkh-2269DiVA: diva2:956689
Available from: 2016-08-31 Created: 2016-08-31 Last updated: 2016-08-31Bibliographically approved

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