OBJECTIVES

: To estimate the direct cost of healthcare resource use by patients with multiple sclerosis (MS) in France in 2014 according to disease severity.

METHODS

: The study was based on the data from the registry of MS in Lorraine (RELSEP) combined with data provided by the main compulsory health insurance linked to the national hospital database (PMSI). All adults MS patients included in the registry in 2013-2014 and not deceased over the period were identified. Costs were identified using the local health insurance database covering salaried workers only. Full hospital pathway of patients was reconstructed after re-identification of individual cases in the PMSI. Mean total costs per patient by disease severity were estimated on a monthly basis taking into consideration potential evolution of MS over the year. Costs of MS exacerbations were estimated using a regression analysis.

RESULTS

: Over the study period, 2166 patients figuring in the RELSEP were included in the study. Ambulatory costs were available for 1,333, and 627 were identified as being hospitalized at least once over 2013-2014. Average annual direct costs for MS patients were estimated to €12,296 in 2014. Ambulatory costs represented 87.8% and were mainly driven by costs of drugs (any type) (60.6%) and paramedics visits (11.2%). Monthly direct costs were higher in patients with severe disease (€ 1,249 for EDSS 7-9) than in patients with mild or moderate disease (€ 992 for EDSS 0-3; € 953 for EDSS 4-6) (p=0,006). Drugs costs were higher in patients with mild disease and conversely costs associated with paramedics, medical devices and transportation were higher in severe MS. Unit cost of exacerbation was estimated to €2,052 to €2,193.

CONCLUSIONS

: MS contributes substantially to health care expenditure in France. Directs costs were mainly driven by drug costs and were highly related to disease severity.