Cost of Illness of Multiple Sclerosis - A Systematic Review

被引:126
作者
Ernstsson, Olivia [1 ,2 ]
Gyllensten, Hanna [2 ]
Alexanderson, Kristina [2 ]
Tinghog, Petter [2 ,3 ]
Friberg, Emilie [2 ]
Norlund, Anders [2 ]
机构
[1] Karolinska Inst, Dept Learning Informat Management & Eth, SE-17177 Stockholm, Sweden
[2] Karolinska Inst, Dept Clin Neurosci, SE-17177 Stockholm, Sweden
[3] Swedish Red Cross Univ Coll, Stockholm, Sweden
基金
瑞典研究理事会;
关键词
UNMET NEEDS TRIBUNE; QUALITY-OF-LIFE; TREATMENT EXPERIENCE; ECONOMIC BURDEN; INTANGIBLE COSTS; MS PATIENTS; DISABILITY; CONSEQUENCES; CARE; UTILITIES;
D O I
10.1371/journal.pone.0159129
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Cost-of-illness (COI) studies of Multiple Sclerosis (MS) are vital components for describing the economic burden of MS, and are frequently used in model studies of interventions of MS. We conducted a systematic review of studies estimating the COI of MS, to compare costs between studies and examine cost drivers, emphasizing generalizability and methodological choices. Material and method A literature search on studies published in English on COI of MS was performed in PubMed for the period January 1969 to January 2014, resulting in 1,326 publications. A mapping of studies using a bottom-up approach or top-down approach, respectively, was conducted for the 48 studies assessed as relevant. In a second analysis, the cost estimates were compared between the 29 studies that used a societal perspective on costs, human capital approach for indirect costs, presenting number of patients included, time-period studied, and year of price level used. Results The mapping showed that bottom-up studies and prevalence approaches were most common. The cost ratios between different severity levels within studies were relatively stable, to the ratio of 1 to 2 to 3 for disability level categories. Drugs were the main cost drivers for MS-patients with low disease severity, representing 29% to 82% of all costs in this patient group, while the main cost components for groups with more advanced MS symptoms were production losses due to MS and informal care, together representing 17% to 67% of costs in those groups. Conclusion The bottom-up method and prevalence approach dominated in studies of COI of MS. Our findings show that there are difficulties in comparing absolute costs across studies, nevertheless, the relative costs expressed as cost ratios, comparing different severity levels, showed higher resemblance. Costs of drugs were main cost drivers for less severe MS and informal care and production losses for the most severe MS.
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页数:25
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