Economic burden of multiple sclerosis in an Italian cohort of patients on disease-modifying therapy: analysis of disease cost and its components

In this observational cross-sectional study conducted in Italy, sociodemographic and disease data were collected from a multiple sclerosis (MS) population treated with disease-modifying therapies (DMTs). A prevalence-based cost-of-illness analysis was subsequently carried out. In total, 393 MS patients were enrolled, 65.9% female, average age of 45 ± 11.5 years. 94.9% had RRMS and EDSS median value of 1.5 (1.0, 2.0). The mean total cost per MS patient was estimated at €20,299.4 per year. Total costs of MS increase by disability level, varying from 16,812.0 (minor) to 20,407.0 (mild), 27,640.7 (moderate), and 44,404.0 (severe). DMT costs accounted for 62.5% of total costs, while productivity loss accounted for 22.0%. Indeed, besides having low quality of life decline and fatigue levels, most patients enrolled retained full working capacity while 31.3% had some productivity loss. The results obtained are in line with previous studies showing that as the disease progresses, the quality of life, fatigue and working capacity worsen alongside a rise in total MS costs for either the society or the healthcare service. Clinical relapses cause a significant cost increment. This cross-sectional study provides a representation of MS quality of life and MS cost in a cohort of Italian MS patients treated with DMT, among which the majority had RRMS. This cost-of-illness analysis can provide useful information for resource allocation and help estimate the savings that can be obtained by slowing the progression of the disease. It also constitutes a primary source of data useful for conducting a complete economic evaluation analysis, including cost-effectiveness and cost-utility analyses.