Direct Costs, Indirect Costs, and Quality of Life Burden of Multiple Sclerosis: National US Estimates (P03.201)

OBJECTIVE: To conduct a comprehensive evaluation of current economic and health-related quality-of-life (HRQoL) burden of multiple sclerosis (MS) in the United States using nationally representative data from the Medical Expenditure Panel Survey (MEPS). BACKGROUND: MS imposes significant but not well-quantified burden on patients, their families/caregivers, employers, and the healthcare system. DESIGN/METHODS: We identified a sample of non-institutionalized patients aged ≥18 with MS (ICD-9 code 340) using MEPS data (1998-2009) and compared them to individuals without MS during the interview year. Cohorts were compared on: healthcare utilization and their associated (direct) costs, indirect costs (including employment status and workdays missed), and HRQoL including quality-adjusted life years (QALYs). Due to measurement limitations of MEPS, we were not able to include all disease modifying therapy (DMT) utilization and related costs. Analyses were modeled using negative binomial, ordinary least squares, and logistic regression, adjusting for demographic and clinical characteristics. RESULTS: Annual MS prevalence was estimated at 572,312 (95% CI: 397,004, 747,619). Annual direct medical expenditures were $11,065 higher for the MS versus non-MS (95% CI: $8,888, $13,242). Annual cost components higher for MS versus non-MS included: outpatient visits $3,443 (95% CI $2,442, $4,445), prescription (excluding DMT) costs $1,834 (95% CI $1,242, $2,427), and inpatient hospitalizations $1,546 (95% CI $39, $3,054). MS patients had a 3.3-fold (95% CI: 2.4, 4.5) increase in the odds of unemployment and a 4.4-fold higher number of days spent in bed (95% CI 2.97, 6.45) versus non-MS. Lifetime average QALYs lost were 10.04 for MS versus non-MS. CONCLUSIONS: Findings confirm that MS patients have higher healthcare costs and utilization than their non-MS counterparts, and are at higher risk for unemployment and lower quality of life. Prevalence of MS is likely higher than previous conservative US estimates but may still be underestimated in this analysis due to the non-institutionalized study population. Supported by: Biogen Idec. Disclosure: Dr. Campbell has received personal compensation for activities with PEcon LLC. Dr. Campbell has received research support from Amgen Inc, Biogen Idec, and Novartis. Dr. Ghushchyan has received personal compensation for activities with Janssen Pharmaceuticals Inc and Biogen Idec as a consultant. Dr. Ghushchyan has received research support from Janssen Pharmaceuticals Inc and Biogen Idec. Dr. McQueen has received personal compensation for activities with Veritech Corporation as a consultant. Dr. Cahoon-Metzger has received personal compensation for activities with Biogen Idec. Dr. Cahoon-Metzger holds stock and/or stock options in Biogen Idec, which sponsored research in which Dr. Cahoon-Metzger was involved as an investigator. Ms. Livingstone has received personal compensation for activities with Biogen Idec. Ms. Livingstone holds stock and/or stock options in Biogen Idec. Dr. Vollmer has received personal compensation for activities with Genzyme Corporation, Acorda Therapeutics, Accelerated Cure Projects for MS, Bristol-Myers Squibb Company, Teva Neuroscience, Biogen Idec, Novartis, and Hoffman-LaRoche. Dr. Vollmer has received research support from Teva Neuroscience, Genzyme Corporation, Ono Pharmaceutical, Biogen Idec, Janssen, and the National Institutes of Health. Dr. Corboy has received personal compensation for activities with ProCE, Celgene Therapeutics, Teva Neuroscience, and Novartis. Dr. Corboy has received personal compensation in an editorial capacity for Neurology Clinical Practice. Dr. Miravalle has received personal compensation for activities with Bayer Healthcare Pharmaceuticals Inc, Biogen Idec, Questcor Pharmacueticals, Inc; EMD Serono, and Teva Neuroscience. Dr. Schreiner has received personal compensation for activities with Teva Neurosciences as lecturer. Dr. Nair has received personal compensation for activities with Centecor, Janssen, and Biogen Idec. Dr. Nair has received research support from Centecor, Janssen, and Biogen Idec.