METHODS: Using data from the EGB database, a 1/97^th random sample of the major French national health insurance system covering about 59 million individuals, we identified adults MS patients considering either long standing condition status (ICD-10 code: G35)/ hospital stays referencing MS as main or related diagnosis/ at least one reimbursement of an MS-specific drug over the 2007-2014 period. The global direct healthcare cost of patients with MS was estimated in a collective perspective. An incremental matched-control approach was then used to estimate the direct burden of MS.

RESULTS: Overall 940 patients with MS were identified on January 1st, 2014. On average they were 50.9 (± 13.7) years old. 71.4% of patients were female. The sum of all 2014 health care expenditure for these patients was estimated to 12,225€ (±12,704€). Nearly all patients (91.7%) were visited at least once during the year by a GP and 38.9% a neurologist. Overall, 44.3% of patients have received at least one delivery of a primary therapy for MS in 2014 mostly beta-interferons and assimilated (28.8%). 22.1% of patients beneficiated of technical aids for their disabilities and 46.9% of patients were treated by a physiotherapist. Finally, 6.2% of patients were hospitalized for MS (average duration of 3.6 days). Comparing MS patients to a matched control group resulted in estimating the excess direct cost attributable to MS to 9,659€ (±6,059€) in 2014 (average annual growth rate: 3.9% over 2012-2014). Main cost drivers were pharmaceuticals (49%), hospital care (22.9%), nursing care (7.8%), medical devices (6.5%) and physiotherapy care (6%).

CONCLUSIONS: The direct burden of MS was evaluated to 965 €million in 2014 in France mainly due to disease-modifying therapies. Such burden highlights the importance of developing cost-effective drugs.