COMPREHENSIVE SOCIETAL RETURN ON INVESTMENT OF PHARMACEUTICALS FOR MULTIPLE SCLEROSIS: A LIFETIME MARKOV MODEL
Author(s)
Jože Sambt, MD1, Uros Rot, MD2, Gregor Jakob Brecl, MD2, Janko Burgar, MSc3, Žana Voh, MSc3.
1University of Ljubljana, Ljubljana, Slovenia, 2University Medical Centre Ljubljana, Ljubljana, Slovenia, 3Roche, d.o.o., Ljubljana, Slovenia.
1University of Ljubljana, Ljubljana, Slovenia, 2University Medical Centre Ljubljana, Ljubljana, Slovenia, 3Roche, d.o.o., Ljubljana, Slovenia.
OBJECTIVES: Calculate the Societal Return on Investment (SROI) for multiple sclerosis (MS) disease-modifying treatments (DMTs) to address limitations in traditional economic evaluations of multiple sclerosis (MS) treatments, which focus solely on direct medical expenditures and omit the broader disease impact. Calculate the Societal Return on Investment (SROI) of disease-modifying treatments (DMTs) using a long-term model incorporating multi-dimensional cost and savings categories. Ensure geographic generalizability and cross-disease scalability, establishing a reusable framework for other countries and therapeutic areas.
METHODS: Developed a long-term, lifetime Markov model for Slovenia using standard European and international databases to ensure cross-border scalability. Grounded the model in a comprehensive cost study of a survey of 571 MS patients (16.3% of MS patients in Slovenia). Incorporated a holistic view of costs, including publicly funded direct medical costs, corporate productivity losses (absenteeism, presenteeism, sick leave), public sector impacts (disability pensions, missed taxes), macroeconomic output declines (lower GDP), household production losses, informal caregiver burdens, and intangible quality-of-life costs such as pain and discomfort. Computed SROI using indicators that progressively "pile up" from narrow financial metrics to an aggregated total societal ROI.
RESULTS: Direct medical costs (€36.4 million annually) represent only about 18% of the total societal burden of MS (€197.1 million annually). The complete societal costs are 3.5 to 5.4 times direct medical expenditures alone. High-efficacy treatments show a clear, positive ROI compared to low- and medium-efficacy options when all saving dimensions are included. Prompt intervention with high-efficacy therapy yields an SROI of up to 1:2.5.
CONCLUSIONS: Restricting evaluations to direct medical costs severely underestimates DMT value; only full societal accounting reveals the true macroeconomic and human value of high-efficacy MS treatments. The model establishes a methodology blueprint using international data structures to capture the true value of healthcare interventions across other countries and therapeutic areas.
METHODS: Developed a long-term, lifetime Markov model for Slovenia using standard European and international databases to ensure cross-border scalability. Grounded the model in a comprehensive cost study of a survey of 571 MS patients (16.3% of MS patients in Slovenia). Incorporated a holistic view of costs, including publicly funded direct medical costs, corporate productivity losses (absenteeism, presenteeism, sick leave), public sector impacts (disability pensions, missed taxes), macroeconomic output declines (lower GDP), household production losses, informal caregiver burdens, and intangible quality-of-life costs such as pain and discomfort. Computed SROI using indicators that progressively "pile up" from narrow financial metrics to an aggregated total societal ROI.
RESULTS: Direct medical costs (€36.4 million annually) represent only about 18% of the total societal burden of MS (€197.1 million annually). The complete societal costs are 3.5 to 5.4 times direct medical expenditures alone. High-efficacy treatments show a clear, positive ROI compared to low- and medium-efficacy options when all saving dimensions are included. Prompt intervention with high-efficacy therapy yields an SROI of up to 1:2.5.
CONCLUSIONS: Restricting evaluations to direct medical costs severely underestimates DMT value; only full societal accounting reveals the true macroeconomic and human value of high-efficacy MS treatments. The model establishes a methodology blueprint using international data structures to capture the true value of healthcare interventions across other countries and therapeutic areas.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE671
Topic
Economic Evaluation, Health Policy & Regulatory, Health Technology Assessment
Disease
Neurological Disorders