A study on the direct and indirect costs of multiple sclerosis based on EDSS score in Khuzestan, Iran

Amin Torabipour, Zahra Ahmadi Asl, Nastaran Majdinasab, Roya Ghasemzadeh, Hammed Tabesh, Arab Mohammad


Background: Multiple sclerosis is a common and chronic neurologic disorder. This disorder imposes physical, economic, and psychosocial burden on individuals, their families and society. This study aims to analyze the costs of multiple sclerosis disease based on the severity of disability.

Methods: We performed a cross‑sectional cost of illness study. This study was conducted in 332 patients of Khuzestan province of Iran. Data were included: Patient’s characteristics, disability status, medical, and nonmedical costs and were gathered by using the questionnaire during 3 months period. Costs analysis was performed in the basis of expanded disability status scale (EDSS). Data were analyzed by using SPSS 18 software.

Results: Mean age of the patients was 33.5 (standard deviation [SD]: 9.1) and 70.5% of patients were female. Mean EDSS score of the patients was 2.2 (SD: 1.6). Most patients (92.1%) had relapsing remitting multiple sclerosis (MS) form of the disease. Costs mean per patients was 8.6 ± 7.9 million Rial. The direct and indirect costs were 93.1% and 6.9% of total costs, respectively. The major cost of the disease belongs to the pharmaceutical treatment (22% of costs). The majority costs (approximately 62%) attributed to EDSS of 6-7 and >7. Furthermore, there was strong significant relationship between cost of illness and disability severity of patients (P < 0.05).

Conclusions: Cost mean per MS patients was relatively high. Furthermore, the results showed that cost of disease had positive and significant relationships with EDSS score that is, progression of disability increase costs of patients.

Keywords: Direct cost, expanded disability status, indirect cost, multiple sclerosis

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