Contextualizing the Impact of Multiple Sclerosis (MS) in England Through HES Analysis

OBJECTIVES: This study aimed to identify the number of patients living with MS in the UK, investigating disease patterns and understanding interaction with healthcare across patient groups.

METHODS: Using NHS Hospital Episode Statistics (HES), the ICD-10 code of G35X and HRG code of AA30 were used to identify a cohort of patients that have presented to care and/or received treatment for MS. The cohort was refined due to inaccuracies in outpatient data coding to count the unique number of patients that have received treatment in the past 5 years. Assumptions and findings were refined using the expert clinal input of Dr David Rog.

RESULTS: The identified population of people living with MS in the UK was estimated to be 121,314 in 2024, compared to the most recent study reporting a population size of 107,300 in 2022. The findings aligned with clinical hypotheses that 71% of people with MS are female, and non-white female patient groups experience the highest prevalence. A lower-than-expected prevalence of MS amongst the most deprived cohorts (deciles 1-3) points towards underdiagnosis. Though diagnosed earlier, once diagnosed, patients from more deprived cohorts are diagnosed at a younger age (42 years in more deprived and 47 years in less deprived), suggesting they may, on average, have more active disease progression. Patients from more deprived backgrounds had a higher proportion of follow-up appointments scheduled but were more likely not to attend outpatient appointments. More deprived cohorts were less likely to travel outside their local area to receive treatment and less likely to receive high-efficacy treatments. This suggests that once diagnosed, the most deprived cohorts face a greater risk of being undertreated.

CONCLUSIONS: This latest HES study of MS identified 3% more people living with MS than previously understood, and indicates significant variation in care across people of different socioeconomic backgrounds.