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An approach to estimating the intangible costs of multiple sclerosis according to disability in Catalonia, Spain

Multiple Sclerosis Unit, Institute of Biomedical Investigation, University Hospital of Bellvitge, Faculty of Medicine, Campus Bellvitge, University of Barcelona, Spain, unitatem{at}csub.scs.es

L. Romero

Multiple Sclerosis Unit, Institute of Biomedical Investigation, University Hospital of Bellvitge, Faculty of Medicine, Campus Bellvitge, University of Barcelona, Spain

L. Gubieras

Multiple Sclerosis Unit, Institute of Biomedical Investigation, University Hospital of Bellvitge, Faculty of Medicine, Campus Bellvitge, University of Barcelona, Spain

L. Alonso

Multiple Sclerosis Unit, Institute of Biomedical Investigation, University Hospital of Bellvitge, Faculty of Medicine, Campus Bellvitge, University of Barcelona, Spain

E. Moral

Multiple Sclerosis Unit, Institute of Biomedical Investigation, University Hospital of Bellvitge, Faculty of Medicine, Campus Bellvitge, University of Barcelona, Spain

S. Martinez-Yelamos

Multiple Sclerosis Unit, Institute of Biomedical Investigation, University Hospital of Bellvitge, Faculty of Medicine, Campus Bellvitge, University of Barcelona, Spain

A. Martinez-Yelamos

Department of Neurology, Hospital de San Lorenzo, Viladecans, Barcelona, Spain

O. Carmona

Department of Neurology, Hospital de Figueres, Girona, Spain

T. Arbizu

Multiple Sclerosis Unit, Institute of Biomedical Investigation, University Hospital of Bellvitge, Faculty of Medicine, Campus Bellvitge, University of Barcelona, Spain

Multiple sclerosis (MS) is a chronic demyelinating disease, which represents a great economic burden to society. Cost-of-illness studies of MS tend to underestimate the intangible costs related to pain, anxiety and helplessness. The purpose of this study was to estimate the intangible costs of MS, and determine whether these costs increase as disability progresses. We studied 211 consecutive patients with MS who attended our MS unit. Patients mean age was 41.6 (SD: 10.7) years, 69% were female, and their mean Expanded Disability Status Scale (EDSS) score was 2.47 (SD: 2.05). Quality-of-life was measured with the EuroQoL visual analogue scale. Quality-adjusted life year (QALY) was calculated for each patient. Patients were grouped into five disability stages according to their EDSS, and QALY was compared between patients and a group of healthy controls matched by age and sex. A benchmark value was ascribed to each QALY lost, and the intangible costs per patient-year were calculated as 0 (EDSS =0), 1100 (EDSS =1-3), 8250 (EDSS =3.5-5.5), 9900 (EDSS =6-7) and 11 000 (EDSS >7.5). Sensitivity analysis showed a similar progression of costs. We conclude that intangible costs are relevant in MS, especially when disability increases. Although the method to calculate the costs remains controversial, we consider that they should be included in cost analysis of MS. Multiple Sclerosis 2007; 13: 800-804. http://msj.sagepub.com

Key Words: disability evaluation • Expanded Disability Status Scale (EDSS) • intangible costs • multiple sclerosis • quality-adjusted life years • quality of life

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