Earnings among multiple sclerosis patients compared to individuals without MS, in total and for different educational levels and types of occupations - a longitudinal population-based cohort study
Author(s): ,
M. Wiberg
Clinical Neuroscience, Karolinska Institutet; Analysis and Prognosis, Swedish Social Insurance Agency, Stockholm
E. Friberg
Clinical Neuroscience, Karolinska Institutet
E. Palmer
Analysis and Prognosis, Swedish Social Insurance Agency, Stockholm; Department of Economics, Uppsala University, Uppsala, Sweden
P. Tinghög
Clinical Neuroscience, Karolinska Institutet
K. Alexanderson
Clinical Neuroscience, Karolinska Institutet
M. Stenbeck
Clinical Neuroscience, Karolinska Institutet
ECTRIMS Online Library. Wiberg M.
Oct 8, 2015; 116666
Michael Wiberg
Michael Wiberg
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Abstract: 92

Type: Oral

Abstract Category: Economic burden

Background: Studies have shown that multiple sclerosis (MS) patients are to a high extent unemployed or do not work full time, but categorized labour market participation is problematic for estimating the potential gradual impact of MS on individuals' work capacity. An alternative measure for labour market participation is continuous earnings. We aimed to examine 1) levels and distribution of earnings of MS patients vs non-MS patients, before and after diagnosis, 2) if differences were associated with educational level and type of occupation, and 3) levels of part and full-time sickness absence and disability pension among MS patients and non-MS patients.

Methods: Using register data of all Swedish residents in 2004 aged 30-54, individuals diagnosed with MS in 2003-2006 were identified (n=2556). Stratified matching based on MS patients' sex and age was used to obtain references without MS (n=7599). Quartiles of earnings were calculated for 16 years, and mean earnings at different levels of education and types of occupation before and after diagnosis were compared using t-tests. Tobit regressions were also performed.

Results: We found increasing differences in levels of earnings between MS patients and references from one year before diagnosis. Also, increasing levels of within-year variation among the MS patients was observed. At year of diagnosis, MS patients had lower mean earnings (difference=28,000 Swedish Crowns, p< 0.05); five years later the difference was more than twice as large (p< 0.05). This negative relationship was also observed among individuals with specific educational levels and types of occupations. However, those with higher education/more qualified occupations were less affected than those with lower education/less qualified occupations. An exception to this was among the often highly qualified leaders, for whom earnings was negatively affected to a high degree. Also, we found increasing proportions of part- and full-time disability pensions received by MS patients after diagnosis.

Conclusions: Our results indicate that MS patients' work capacity gradually decreased. Both educational level and type of occupation appeared to be influential factors for explaining the large heterogeneity among MS patients. We also found that part- or full-time usage of the sickness insurance systems could potentially be used to describe the heterogeneity.

Study supported by Biogen and the Swedish Research Council for Heath, Working Life, and Welfare.


MW and PT were funded by Biogen.

EF, EP, KA, and MS have no disclosures to declare.

This study was also funded by the Swedish Research Council for Health, Working Life and Welfare (2007-1762).

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