OBJECTIVES: to estimate the incidence of multiple sclerosis (MS) patients having access to social security benefits in Italy in 2016-2019.

METHODS: the Italian Social Security System registers all new applications submitted, along with the related opinions (acceptance or rejection) expressed by medical managers, with an indication of prevailing diagnosis. All applications submitted by subjects of age 18+ with a prevailing diagnosis of MS between 2016 and 2019 were retrieved. The age and sex distribution, as well as the number of applications by region of residence were estimated. Results were stratified by type of social benefit: incapacity pensions (for people without work ability), disability pensions and disability benefits (for people with reduced work ability).

RESULTS: 99.8% of the 16,621 applications for incapacity benefits have been accepted. Although the number of new applications remained costant across years, the applicants obtaining a pension with attendance allowance (the highest degree of disability) decreased (-11.1%) with respect to the ones obtaining partial incapacity pensions (+13.2%). 66% of applicants were women, with the population 65+ representing the 8.1% of total. The regional distribution of applications was characterized by high heterogeneity, with the Sardegna region recording the highest annual incidence of accepted applications (29.3 per 100,000 resident). In the same period 7,338 applications were recorded for people with reduced work ability: the rejection rate was 39%, 49% of the applicants obtained disability benefits and 12% disability pension. No difference by sex was observed, while age category 41-60 included 75% of applicants. Regional patterns by type of social benefit recognized were highly heterogeneous.

CONCLUSIONS: this analysis showed that most of the applicants belong to the working-age, not only MS impacts health and well-being, but it also represents a major economic burden in terms of loss of productivity.