OBJECTIVES: To assess the potential impact of cognitive impairment (CI) on the disease burden in Chinese patients with newly diagnosed relapsing-remitting multiple sclerosis (RRMS), the most common demyelinating disease of central nervous system.

METHODS: A Markov model was designed to simulate the risk of CI, risk of developing secondary progressive MS (SPMS), and mortality risk in Chinese patients with newly diagnosed RRMS (mean age: 36.6 years; female: 63.8%). A model cohort of age and gender-matched Chinese general population was created as the control. Literature-based evidence was used to estimate model inputs. The cumulative risk of CI, life years, quality-adjusted life years (QALY), and lifetime costs associated with the two model cohorts were compared to measure the disease burden in base case analysis and sensitivity analysis.

RESULTS: In the base case analysis, Chinese patients with newly diagnosed RRMS were associated with high lifetime cumulative risk of developing CI (85.2%). Relative to the matched Chinese general population, newly diagnosed RRMS patients had a shorter life expectancy (33.2 years vs. 41.7 years, difference: -8.5 years), less QALY (18.4 QALY vs. 38.4 QALY, difference: -19.9 QALY), and higher lifetime costs (direct medical costs: ¥613,883 vs. ¥202,726, difference: ¥411,157; indirect costs: ¥1,099,021 vs. ¥94,612, difference: ¥1,004,410). The patients with developed CI alone the simulation process accounted for 99.9% of reduced life years, 76.0% of the reduced QALY, 55.8% of the increased lifetime medical costs, and 79.2% of the increased lifetime indirect costs, respectively. The measured disease burden was mainly driven by the risk of developing CI, progression to SPMS, mortality risk associated with CI, utility associated with RRMS, disease relapse, and personal care costs.

CONCLUSIONS: Most Chinese patients with newly diagnosed RRMS would develop CI in their lifetime and patients with developed CI could make a major contribution to the disease burden of RRMS.