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Home / Systematic Review of Economic Evaluation in Multiple Sclerosis

Systematic Review of Economic Evaluation in Multiple Sclerosis

. 2021 Jul;39(7):789-807.

doi: ten.1007/s40273-021-01032-7. Epub 2021 May 6.

Economic Burden of Multiple Sclerosis in Low- and Middle-Income Countries: A Systematic Review

Affiliations

  • PMID: 33956330
  • PMCID: PMC8200340
  • DOI: 10.1007/s40273-021-01032-7

Gratuitous PMC article

Economic Brunt of Multiple Sclerosis in Low- and Middle-Income Countries: A Systematic Review

Jalal Dahham  et al. Pharmacoeconomics. 2021 Jul .

Gratis PMC article

Abstruse

Background: Although the economic burden of multiple sclerosis (MS) in high-income countries (HICs) has been extensively studied, information on the costs of MS in low- and centre-income countries (LMICs) remains deficient. Moreover, no review synthesizing and assessing the costs of MS in LMICs has all the same been undertaken.

Objective: Our objective was to systematically identify and review the price of illness (COI) of MS in LMICs to critically appraise the methodologies used, compare toll estimates across countries and by level of disease severity, and examine cost drivers.

Methods: Nosotros conducted a systematic literature search for original studies in English, French, and Dutch containing prevalence or incidence-based cost data of MS in LMICs. The search was conducted in MEDLINE (Ovid), PubMed, Embase (Ovid), Cochrane Library, National Health Service Economic Evaluation Database (NHS EED), Econlit, and CINAHL (EBSCO) on July 2020 without restrictions on publication date. Recommended and validated methods were used for data extraction and analysis to make the results of the COI studies comparable. Costs were adapted to $US, year 2019 values, using the World Bank purchasing ability parity and inflated using the consumer price alphabetize.

Results: A total of 14 studies were identified, all of which were conducted in upper-middle-income economies. Eight studies used a bottom-up arroyo for costing, and six used a top-down approach. Four studies used a societal perspective. The total annual cost per patient ranged betwixt $US463 and 58,616. Costs varied across studies and countries, mainly because of differences regarding the inclusion of costs of disease-modifying therapies (DMTs), the range of cost items included, the methodological choices such as approaches used to estimate healthcare resource consumption, and the inclusion of informal intendance and productivity losses. Characteristics and methodologies of the included studies varied considerably, especially regarding the perspective adopted, price information specification, and reporting of costs per severity levels. The total costs increased with greater disease severity. The cost ratios between unlike levels of MS severity within studies were relatively stable; costs were effectually 1-1.5 times higher for moderate versus mild MS and well-nigh 2 times higher for astringent versus mild MS. MS drug costs were the main cost driver for less severe MS, whereas the proportion of direct not-medical costs and indirect costs increased with greater disease severity.

Conclusion: MS places a huge economic burden on healthcare systems and societies in LMICs. Methodological differences and substantial variations in terms of absolute costs were establish betwixt studies, which made comparison of studies challenging. Withal, the toll ratios beyond different levels of MS severity were similar, making comparisons between studies past disease severity feasible. Cost drivers were mainly DMTs and relapse treatments, and this was consistent across studies. Yet, the distribution of price components varied with disease severity.

Disharmonize of involvement statement

Jalal Dahham, Rana Rizk, Ingrid Kremer, Silvia M.A.A. Evers, and Mickaël Hiligsmann have no conflicts of interest that are direct relevant to the content of this article.

Figures

Fig. 1
Fig. ane

PRISMA flowchart of study option. COI cost of disease, MS multiple sclerosis

Fig. 2
Fig. ii

Annual cost per patient by Expanded Inability Status Scale (EDSS) nomenclature grouping adapted to $U.s.a., twelvemonth 2019 values, and toll ratios for bottom-up studies. Note that Chanatittarat et al. [54] did not report any cost by EDSS classification. °Data courtesy of Prof. Gisela Kobelt [44] via personal communication. oneData well-nigh EDSS level was unavailable for two patients in da Silva et al. [48]. twoEDSS information was missing for 20 patients in Boyko et al. [47]. 3To obtain the cost per patient per twelvemonth for the study by Torabipour et al. [46] from Iran, we annualized resources used past assuming that collected information on resource were representative of patient use over the whole twelvemonth

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Source: https://pubmed.ncbi.nlm.nih.gov/33956330/