Scandinavian Working Papers in Economics
SSE/EFI Working Paper Series in Economics and Finance,
Stockholm School of Economics
No 398: Costs and Quality of Life in Multiple Sclerosis. A Cross-Sectional Observational Study in the UK
Gisela Kobelt, Peter Lindgren (peter.l@healtheconomics.se), David Parkin (d.parkin@city.ac.uk), David A. Francis (d.a.francis@bham.ac.uk), Michael Johnson (michael.johnson@leedsth.nhs.uk), David Bates (david.bates@ncl.ac.uk) and Bengt Jönsson (bengt.jonsson@hhs.se)
Additional contact information
Gisela Kobelt: Health Dynamics International Ltd., Postal: High Wycombe, United Kingdom
Peter Lindgren: Stockholm Health Economics Consulting AB, Postal: Stockholm, Sweden
David Parkin: Department of Economics, City University, Postal: London, United Kingdom
David A. Francis: Neurosciences Center, University Hospital Birmingham, Postal: Birmingham, United Kingdom
Michael Johnson: Department of Neurology, St Jame´s University Hospital, Postal: Leeds, United Kingdom
David Bates: Department of Neurology, Royal VIctoria Infirmary, Postal: Newcastle upon Tyne, United Kingdom
Bengt Jönsson: Dept. of Economics, Stockholm School of Economics, Postal: Stockholm School of Economics, P.O. Box 6501, S-113 83 Stockholm, Sweden
Abstract: Abstract: We performed a cross-sectional, "bottom-up" observational study of resource consumption and quality of life of patients with multiple sclerosis (MS) in the United Kingdom. Three centers participated in the study. Patients received a questionnaire either by mail or during a clinic visit, and a total of 619 patients returned the questionnaire (the answer rate being around 70%). Patients provided information on all resource consumption, medical and non-medical, work absence and informal care related to their MS. Disease scores (Expanded Disability Status Scale, EDSS) were available for a majority of patients from the study centers, and were assigned using a matrix of disease (mobility) descriptions and EDSS scores. Mean total cost per patient and year was 16’717 £. When this cost is extrapolated to an estimated patient population in the UK of 80’000, total costs to society are estimated at 1.34 billion £. Direct costs represented 28%, informal care accounted for 26% and indirect costs amounted to 46%. Of the direct costs, an estimated £ per patient or % of total costs are paid for by the NHS. Intangible costs were estimated at 5000 £ per patient and year.
The mean age of the cohort was 44 years (disease onset 34), the mean utility measured with EQ-5D was 0.487 (0.919 to –0.594), and the mean EDSS score 5.1 (1.0 to 9.5). All costs (direct, informal care, indirect) increased with increasing EDSS scores, while utilities decreased.
Keywords: multiple sclerosis; cost-of-illness; quality of life; EDSS; utility
JEL-codes: D61; H42; H51; H55; I18
35 pages, October 4, 2000
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