Cost and Quality of Life of Disability Progression in Multiple Sclerosis Beyond EDSS: Impact of Cognition, Fatigue, and Limb Impairment

Jürgen Wasem, Yanic Heer, Eleni Karamasioti, Erwan Muros-Le Rouzic (), Giuseppe Marcelli, Danilo Maio, Stefan Braune, Gisela Kobelt and Paul Dillon
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Jürgen Wasem: University of Duisburg-Essen
Yanic Heer: PricewaterhouseCoopers (PwC)
Eleni Karamasioti: PricewaterhouseCoopers (PwC)
Erwan Muros-Le Rouzic: F. Hoffmann-La Roche Ltd.
Giuseppe Marcelli: F. Hoffmann-La Roche Ltd.
Danilo Maio: F. Hoffmann-La Roche Ltd.
Stefan Braune: NeuroTransData GmbH
Gisela Kobelt: EHE International
Paul Dillon: F. Hoffmann-La Roche Ltd.

PharmacoEconomics - Open, 2024, vol. 8, issue 5, No 3, 665-678

Abstract: Abstract Background and Objective Understanding the socioeconomic burden of multiple sclerosis (MS) is essential to inform policymakers and payers. Real-world studies have associated increasing costs and worsening quality of life (QoL) with disability progression. This study aims to further evaluate the impact of cognition, fatigue, upper and lower limb function (ULF, LLF) impairments, and disease progression per Expanded Disability Status Scale (EDSS) level, on costs and QoL. Methods This was a cross-sectional cohort study including 20,988 patients from the German NeuroTransData MS registry from 2009 to 2019. QoL analyses were based on EQ-5D-5L. Cost analyses included indirect/direct medical and non-medical costs. Eight subgroups, ranging from 439 to 1812 patients were created based on presence of measures for disease progression (EDSS), cognition (Symbol Digit Modalities Test [SDMT]), fatigue (Modified Fatigue Impact 5-Item Scale [MFIS-5]), ULF (Nine-Hole Peg Test [9HPT]), and LLF (Timed 25-Foot Walk [T25FW]). Multivariable linear regression assessed the independent effect of each test’s score on QoL and costs, while adjusting for EDSS and 12 other confounders. Results Lower QoL was associated with decreasing cognition (p

Date: 2024
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DOI: 10.1007/s41669-024-00501-x

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