Disease burden and costs associated with multiple sclerosis in China: A cross-sectional analysis of nationwide survey data

Abstract

Abstract Background Multiple sclerosis (MS) imposes a huge burden on patients, not only physically, due to progressive disability, but also financially, due to reduced productivity and high utilization of healthcare resources. Little is known about the costs associated with MS for patients in China. This study aimed to estimate the disease burden of MS in China and the economic impact of MS and its association with disability severity, thereby providing empirical data to inform public health decision-making. Methods This was a retrospective, cross-sectional study using a self-reported online survey. Data were collected from MS patients including demographic information, employment status, health-related quality of life, resource utilization, and associated costs. The severity of the disability status of MS patients was identified by a proxy question for the Expanded Disability Status Scale (EDSS). Regression analysis was applied to estimate the association between costs and disease severity. Results A total of 477 MS patients were included in the study. The mean age was 34.5 years, and 65.6% were female. The employment rate was 50.3%. The average total annual costs for an MS patient were approximately 168,228 CNY (23,720 USD) in China. The mean utility value was estimated at 0.808 for patients with EDSS < 4, 0.437 at EDSS 4–6, and 0.017 at EDSS > 6. Total annual costs of MS were 154,673 CNY (21,809 USD) at EDSS < 4, 187,038 CNY (26,372 USD) at EDSS 4–6, and 235,390 CNY (33,190 USD) at EDSS > 6. This study further found a significant association between disability severity and indirect costs due to MS. Conclusions Our findings identified severe disease burden and costs among MS patients in China. Higher costs were imposed on MS patients as the severity of disability increased, and the increase in the economic burden of MS was mainly driven by a dramatic increase in indirect costs. This study highlights the importance of slowing the progression of MS to reduce indirect costs of MS patients and provides empirical data for further policy review and reform.