Increased socioeconomic burden in patients with primary progressive multiple sclerosis: a Danish nationwide population-based study
ECTRIMS Online Library. Blinkenberg M. Sep 11, 2019; 278815; P455
Morten Blinkenberg
Morten Blinkenberg

Abstract: P455

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Economic burden

M. Blinkenberg1, J. Kjellbjerg2, R. Ibsen2, M. Magyari3

1Danish MS Center, Dept. of Neurology, Copenhagen University Hospital, Rigshospitalet, 2VIVE, The Danish Center for Social Science Research, 3The Danish Multiple Sclerosis Registry, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

Introduction: Socioeconomic stability is relatively well preserved in people with relapsing-remitting multiple sclerosis (RRMS), especially in those who respond to disease modifying treatment. Unfortunately, this is not true for the progressive course of the disease, primary progressive and secondary progressive MS (PPMS and SPMS), where most disease modifying treatments have proven to be non-efficacious in clinical trials.
Objective: To determine whether global measures of socioeconomic burden of PPMS and SPMS are increased compared with RRMS.
Methods: We included patients from the Danish Multiple Sclerosis Registry diagnosed between 1998-2015. Yearly average health costs, public transfers and earned income was calculated based on MS patients costs and income from their index diagnosis date to 31.12.2015. Health costs, public transfer and income were calculated each year in a 5 years period before and after patient index diagnosis date for each of the 3 groups. A regression model estimating the odds ratio (OR) was used to analyze the differences in the 3 groups controlling for age and gender.
Results: In total, 9563 MS patients were identified (1998-2015), with a characteristic distribution between different disease courses: 7012 patients with RRMS (73%), 1099 patients with PPMS (11%) and 1452 patients with SPMS (15%). Total health costs were increased in PPMS patients compared with RRMS patients (OR 0,76; 95% CI 0,74-0,78; p< 0,0001) but not for PPMS vs. SPMS (OR 1,06; 95% CI 1,03-1,09; p< 0,0001). Homecare costs showed pronounced difference (OR 0,17; 95% CI 0,17-0,18; p< 0,0001) with increase for PPMS compared with RRMS, and difference between PPMS and SPMS much less pronounced (OR 0,93; 95% CI 0,90-0,97; p=0,0001). OR for earned income was more than two-fold increased for PPMS patients compared with RRMS patients (OR 2,08; 95% CI 2,03-2,13; p< 0,0001), less pronounced for SPMS patients (OR 1,38; 95% CI 1,35-1,41; p< 0,0001). OR for health costs each year before and after diagnosis was significantly decreased for PPMS vs. RRMS regarding most variables, whereas differences between SPMS and PPMS before and after diagnosis generally were nonsignificant.
Conclusion: This nationwide population based study, using extensive socioeconomic data, evaluating health costs and income during an 18-year period, show that socioeconomic burden is significantly higher for people with PPMS relative to people with RRMS, but less pronounced compared to people with SPMS.
Disclosure: Melinda Magyari have served on scientific advisory board for Biogen, Sanofi, Teva, Roche, Novartis, Merck, have received honoraria for lecturing from Biogen, Merck, Novartis, Sanofi, Genzyme, have received research support and support for congress participation from Biogen, Genzyme, Teva, Roche, Merck, Novartis.
Morten Blinkenberg have served on scientific advisory boards for Sanofi-Genzyme, Roche, Biogen, Merck, Novartis and Teva; have received speaker honoraria from Sanofi-Genzyme, Biogen, Merck, Novartis, Teva and Roche; have received consulting honoraria from the Danish Multiple Sclerosis Society, Sanofi-Genzyme, Biogen, Teva, Roche and Merck; and have received funding for travel from Sanofi-Genzyme, Roche and Biogen.
Jakob Kjellberg and Rikke Ibsen have nothing to disclose

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