COSTS BY DISABILITY SEVERITY AND ASSOCIATION WITH EDSS IN MULTIPLE SCLEROSIS ACROSS EU5: A TARGETED LITERATURE REVIEW
Author(s)
Ines Hemim, Pharma D, MHE1, Sirish Cholasamudram, MPharm2, Dhorababu Karamsetty, MPharm2, Nupur Greene, PhD, MPH, BPharm3.
1Sanofi, Gentilly, France, 2Sanofi Healthcare India Private Limited, Hyderabad, India, 3Sanofi, Cambridge, MA, USA.
1Sanofi, Gentilly, France, 2Sanofi Healthcare India Private Limited, Hyderabad, India, 3Sanofi, Cambridge, MA, USA.
OBJECTIVES: Disability accumulation in multiple sclerosis (MS), measured using Expanded Disability Status Scale (EDSS), is associated with substantial economic burden. This targeted literature review summarised evidence on costs stratified by disability severity and associations between EDSS and costs incurred by people with MS.
METHODS: The Embase database was searched through October 2024. Studies reporting costs by EDSS category (defined by individual studies) and correlations/regression analyses evaluating the association of EDSS and costs (without currency-standardization) from Germany, France, Italy, Spain, and the United Kingdom (UK) were included.
RESULTS: Twenty-eight studies were included. Mean total costs per patient per year (PPPY) ranged from €16,812-34,851 in mild and €41,357-68,700 in severe MS. Mean total costs PPPY increased progressively with disability severity across all countries. For mild disease, costs were €18,971-28,200 (Germany), €22,600-23,968 (France), €16,812-29,676 (Italy), €20,600-34,851 (Spain), and £11,400 (UK); for severe disease, costs were €58,576-62,700, €41,357-48,100, €44,042-63,047, €68,700, and £36,500, respectively. Primary cost drivers at higher disability were direct non-healthcare and indirect costs; direct healthcare costs predominated in mild disease. EDSS correlated positively and significantly with total costs (France: r=0.628, p<0.001; UK: r=0.348, p=0.001). Regression analyses (β) demonstrated consistent positive associations between EDSS and costs. In Germany, EDSS was an independent predictor of total costs (β=0.298, p<0.001), indirect costs (β=0.521, p<0.001), and drug costs (β=−0.294, p<0.001). In Italy, each 1-point increase in EDSS was associated with a 48% increase in total annual costs (β=0.48, p<0.001). In the UK, each 1-point increase in EDSS was associated with a mean cost increase of £5,985.
CONCLUSIONS: Evidence demonstrates that increases in EDSS score are significantly associated with higher total and indirect costs across these countries. These findings highlight substantial economic impact of disability accumulation and underscore the importance of early and effective disease management to delay disability progression in MS.
METHODS: The Embase database was searched through October 2024. Studies reporting costs by EDSS category (defined by individual studies) and correlations/regression analyses evaluating the association of EDSS and costs (without currency-standardization) from Germany, France, Italy, Spain, and the United Kingdom (UK) were included.
RESULTS: Twenty-eight studies were included. Mean total costs per patient per year (PPPY) ranged from €16,812-34,851 in mild and €41,357-68,700 in severe MS. Mean total costs PPPY increased progressively with disability severity across all countries. For mild disease, costs were €18,971-28,200 (Germany), €22,600-23,968 (France), €16,812-29,676 (Italy), €20,600-34,851 (Spain), and £11,400 (UK); for severe disease, costs were €58,576-62,700, €41,357-48,100, €44,042-63,047, €68,700, and £36,500, respectively. Primary cost drivers at higher disability were direct non-healthcare and indirect costs; direct healthcare costs predominated in mild disease. EDSS correlated positively and significantly with total costs (France: r=0.628, p<0.001; UK: r=0.348, p=0.001). Regression analyses (β) demonstrated consistent positive associations between EDSS and costs. In Germany, EDSS was an independent predictor of total costs (β=0.298, p<0.001), indirect costs (β=0.521, p<0.001), and drug costs (β=−0.294, p<0.001). In Italy, each 1-point increase in EDSS was associated with a 48% increase in total annual costs (β=0.48, p<0.001). In the UK, each 1-point increase in EDSS was associated with a mean cost increase of £5,985.
CONCLUSIONS: Evidence demonstrates that increases in EDSS score are significantly associated with higher total and indirect costs across these countries. These findings highlight substantial economic impact of disability accumulation and underscore the importance of early and effective disease management to delay disability progression in MS.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE59
Topic
Economic Evaluation, Patient-Centered Research, Study Approaches
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Work & Home Productivity - Indirect Costs
Disease
Neurological Disorders, No Additional Disease & Conditions/Specialized Treatment Areas