OBJECTIVES: Multiple system atrophy (MSA) is a rare and progressive neurological disorder affecting various bodily systems. Our systematic literature review focused on evaluating the overall humanistic and economic burden associated with MSA and identify any existing gaps in the current evidence.

METHODS: A comprehensive literature search was performed across Medline and Embase databases. Studies published in the English language between January 2013 and June 2023 reporting the humanistic and economic burden of MSA were included using pre-defined eligibility criteria.

RESULTS: Of the 2357 studies identified, a total of 43 studies focused on humanistic burden and three studies examining economic burden of MSA were included. Health-related quality of life (HRQoL) was assessed using both generic and MSA-specific instruments, with UMSARS (n=27 studies), UPDRS (n=8), PDQ (n=7) scales being used more commonly across the included studies.

The findings from these studies suggest that individuals with MSA-P (parkinsonian subtype) experience more severe motor impairment, hyposmia (reduced sense of smell), depression, anxiety, cognitive impairment, and lower HRQoL compared to those with MSA-C (cerebellar subtype). One study indicated that non-motor symptoms are more prevalent and severe in MSA-P patients, particularly in terms of mood/apathy and gastrointestinal symptoms.

Most of the studies examining the economic burden of MSA were conducted in North America and Europe. These studies revealed that the average annual cost of care per diagnosed MSA patient was US$9405, with only US$1782 directly attributed to MSA-related encounters. One study reported resource utilisation, indicating that most participants, 96% and 70.2%, had visited >1 family physician and emergency department, respectively. Additionally, 62% of individuals had been hospitalised multiple times, and 25.5% spent more than 30 days in the hospital.

CONCLUSIONS: These findings highlight the considerable humanistic and economic challenges faced by individuals living with MSA. Further research is needed to better quantify the economic burden associated with MSA.