SSE/EFI Working Paper Series in Economics and Finance
Gisela Kobelt, Peter Lindgren
Costs and Quality of Life in Multiple Sclerosis. A Cross-Sectional Observational Study in Germany
(), Antje Smala and Bengt Jönsson
Abstract: We performed a cross-sectional, “bottom-up” observational
study of resource consumption and quality of life of patients with multiple
sclerosis (MS) in Germany. Six centers participated in the study. Patients
were asked to complete a questionnaire, and a total of 737 patients
returned the questionnaire (the answer rate being 66%). The questionnaire
provided information on all resource consumption, medical and non-medical,
work absence and informal care related to their MS. Simultaneously, medical
charts were also abstracted for a sub sample of 202 patients. For this sub
sample, disease scores (Expanded Disability Status Scale, EDSS) were
available from the study centers. For the remainder, disease scores were
assigned using a matrix of disease (mobility) descriptions and EDSS scores.
Mean total cost per patient and year was 65,400 DM, adjusted for usage of
interferons, which was higher in this sample than the current average usage
in Germany. When this cost is extrapolated to an estimated patient
population of 120,000, total costs to society are estimated at 7.85 billion
DM. Direct costs represented 57.5%, informal care accounted for 12.1% and
indirect costs amounted to 42.5%. An estimated 24,800 DM per patient or 38%
of total costs are paid for by public payers. Intangible costs were
estimated 16,650 DM per patient and year.
The mean age of the cohort
was 42 years (disease onset 33), the mean utility measured with EQ-5D was
0.552 (0.919 to –0.429), and the mean EDSS score 4.4 (1.0 to 9.5). All
costs (direct, informal care, indirect) increased with increasing EDSS
scores, while utilities decreased.
Keywords: Keywords: multiple sclerosis; cost-of-illness; quality of life; EDSS; utility; (follow links to similar papers)
JEL-Codes: D61; H42; H51; H55; I18; (follow links to similar papers)
47 pages, October 4, 2000
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