Health Utilities and Costs for Multiple Sclerosis.

Abstract

Background: Multiple sclerosis (MS) is a chronic neurological condition that imposes a significant burden on patients and healthcare systems.

Objectives: To estimate health utilities and costs of MS within the UK setting.

Methods: Patients with MS recruited to the Trajectories of Outcomes in Neurological Conditions (TONiC-MS) study completed a survey that included the EuroQoL EQ-5D-5L, EQ VAS, and a resource use questionnaire for recording their use of MS-related primary, secondary and community care services, diagnostic tests and medicines in the previous 3 months. Data were analysed descriptively and using regression models.

Results: Of 10,031 patients invited to participate, 5,913 (58.9%) returned their survey questionnaires. Overall, participants' mean (95% CI) utilities scores were 0.576 (0.568, 0.583). These were highest for those with relapsing remitting MS 0.667 (0.659, 0.675) and lowest in secondary progressive MS 0.385 (0.368, 0.402). Utility scores ranged from 0.727 (0.720, 0.734) for participants with 0≤EDSS≤4.0, to 0.125 (0.089,0.162) with 8.0≤EDSS≤9.5. Total, 3-month MS-related costs were £2807 (£2665, £2974), ranging from £809 (£563, £1188) for those within 8.0≤EDSS≤9.5 and primary progressive MS, and £9390 (£4601, £23101) for those with 7.0≤EDSS≤7.5 and rapidly evolving MS. Age, sex, MS types, EDSS scores, and some interactions between EDSS band scores and MS types explained variability in both health utilities and costs.

Conclusions: The impact of MS on health utilities and costs differs by MS type, disability scores and their interaction. These data can be used in cost-effectiveness analyses to inform healthcare decision-making.