OBJECTIVES

The introduction of disease-modifying therapies (DMTs) for patients with Expanded Disability Status Scale (EDSS)<7 and the improvement of diagnostic tests over the past two decades had profound effects on the management of Multiple sclerosis (MS). Aim of this study was assessing the change in costs, pharmacological treatments and healthcare resources consumptions in MS centers population with EDSS<7 over time.

METHODS

MS registries available in two main Italian MS centers collected data from at least 2000 and reported information on MS courses, diseases severity, pharmacological treatment, hospitalizations, diagnostic exams, ambulatory care, and specialistic visits. Based on the available data from 2000 to 2016, annual healthcare resources consumption and mean annual per capita cost were estimated for each calendar year. Differences of the healthcare resources consumptions and costs over time were compared by Cochran-Armitage test for trend.

RESULTS

The study identified 3,815 patients with 95.3% of them reporting an EDSS<7 (mean(SD) age = 37.3(11.8) years). Patients with EDSS<7 in charge of the two centers increased significantly from 685 in 2000 to 2,252 in 2016. RRMS was the most prevalent condition in all years (81.9% in 2001, 95.0% in 2016). Percentage of patients treated with DMTs increased from ~25% in 2000 to ~50% in 2016 (p<0.01). The first treatment provided to patients change from interferon (95.6%) to Dimethyl fumarate, Glatiramer Acetate and Teriflunomide (58.2%). Except hospitalization, health care resource utilization increased during the observed years (p<0.01). The mean cost per patient-year increased from €3,236 in 2000 to €6,842 in 2014 (p<0.01). While in the last two years the mean cost slightly decreased to around €6,000.

CONCLUSIONS

Costs associated to MS patients’ management significantly increased over time with the availability of new DMTs and a higher proportion of patients treated. Local databases holding mainly clinical data allowed a more accurate estimate of costs from MS centers perspective.