High Disability Levels in MS Associated With Higher Costs, Lower Quality of Life


As levels of disability increased among patients with multiple sclerosis (MS), cost of illness increased and health-related quality of life decreased.

Patients with multiple sclerosis (MS) incur higher costs and experience lower health-related quality of life as their disability increases, according to study findings.

Due to the early onset of MS, people are often affected during working ages, impacting not only direct costs, such as healthcare and medication, but indirect costs as well, such as productivity loss. Due to pain and both direct and indirect costs, quality of life also suffers.

However, according to the study researchers, “important developments have occurred in the treatment of MS since the mid-1990s and onwards, potentially changing both the costs and health outcomes among people with MS since previous estimates.”

To read more on the impact of MS progression, click here.

For updated estimates, the researchers linked 2013 microdata from Swedish nationwide registers on patients with MS aged 21 to 64 years. They collected data on direct costs—prescription drug use and specialized healthcare—and indirect costs—sick leave and disability pension. They also compiled data on health-related quality of life from the registries. Disability levels were measured on a scale from 0 to 10.

The researchers noted that nonmedical costs such as personal assistance and informal care, which are often high among patients with MS, were not captured in this data.

Men, older patients, and those with a lower education level were more likely to have higher levels of disability compared with other patients with MS.

Costs totaled approximately $32,000 for those with a disability level of 3.5 or less, $55,000 for those with a disability level of 4 to 5.5, $65,000 for those with a disability level of 6 to 6.5, and $76,000 for those with a disability level of 7 or higher.

The researchers observed that prescription drugs accounted for 40% of the cost of illness among patients with low levels of disability (≤3.5). Meanwhile, among patients with high levels of disability (≥7), the cost of illness was largely driven by higher indirect costs, which represented 92% of the cost of illness. The largest driver of indirect costs was sick leave among those with mild disability levels (4-5.5).

Patients with high levels of disability also had inpatient care costs that were 4 times higher than those among patients with low levels of disability.

Notably, the mean cost of inpatient care was more than 4 times greater among those with high levels of disability compared with those with low levels of disability.

Higher levels of disability also translated into lower health-related quality of life. Those with lower levels of disability reported an average higher estimated health-related quality of life, while those with high levels of disability had the lowest health-related quality of life.


Gyllensten H, Kavaliunas A, Alexanderson K, et al. Costs and quality of life by disability among people with multiple sclerosis: a register-based study in Sweden [published online July 9, 2018]. SAGE Open. doi: 10.1177/2055217318783352.

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