Costs, Quality of Life and Disease Severity in Multiple Sclerosis - A Population-Based Cross-Sectional Study in Sweden

This study has used a cross-sectional, 'bottom-up' design to determine the cost to society of multiple sclerosis (MS) in Sweden in 1998. The total cost of MS was estimated at 4 868 MSEK, meaning an annual cost of 442 500 SEK per patient. Direct costs accounted for about 67% of total cost, and direct costs were dominated by the cost of personal assistants and drugs. Indirect costs accounted for about 33% of total costs and were totally dominated by the cost of long-term sickness absence from work and early retirement. Intangible costs were estimated at 2 700 MSEK. A former Swedish study on MS for 1994, using main diagnosis to calculate costs, showed the total cost to be 1 736 MSEK. Increased disability as measured by EDSS was found to have a major impact on the cost of the disease and on quality of life. Both direct, indirect and informal care costs rose significantly with increased EDSS and were higher during a relapse. Quality of life declined substantially with increased EDSS and was lower during a relapse. In summary, this study showed that a severe, chronic, disabling disease like MS that strikes early in life has major implications for both the society as a whole and for the affected patients.