Patients With MS Have Lower Income Development Compared With Healthy Controls

A diagnosis of multiple sclerosis (MS) could have significant impacts on the income of patients with the condition in the long term, according to a new study published in the European Journal of Neurology.¹ Patients with MS had lower income development when compared with other healthy controls, indicating disparities in quality of life for patients.

Patients with MS, a chronic autoimmune disease, can have various presentations of the disease, including a rapid progression that impairs physical and cognitive functioning. A period prior to the onset of MS has also been identified where patients who are later diagnosed with MS have an increased use of health care services and prescription medications and also can show reduced cognitive performance.² This study aimed to assess the trajectory of gross income in patients with MS compared with healthy controls, including identifying when the difference in income begins.¹

The study was based on the Norwegian BOT-MS registry, which includes data on wages, capital gains, and government transfers for all patients in the registry. Data from 1993 through 2017 were collected for the study. Controls were matched based on age, sex, and place of residence when aged 16 years. Patients with income above the 99^th percentile were excluded from the study. Income development was evaluated in patients born between 1950 and 1984. The patients were separated into 7 groups based on birth year. For income analysis relative to diagnosis, only patients who were of working age throughout the entire study period were included, and patients were separated into groups based on the year of diagnosis.

There were 1071 patients with MS and 15,493 controls who were included in the study, of whom 72% were women. The median (IQR) age of the participants was 40 (17) years.

The researchers found that men with MS and women with MS had significantly lower income growth, and specifically lower income growth in women with MS born between 1955 and 1964. The results for men with MS were only significant in those born between 1960 and 1964, and no significant results were found in patients born after 1965.

Income growth was significantly lower in patients with MS of both sexes between the ages of 50 and 66 years. Men with MS had lower income growth between 49 and 67 years, though the age of 50 years was not significant in this group. Women with MS had significantly lower income growth between the ages of 55 and 62 years, with 1 year of nonsignificance at 60 years. Men with MS had similar income to the controls through 40 years before diverging, whereas women had similar income to their controls through 43 years; these income disparities closed for women with MS toward the age of retirement.

The income increase rate was lower in patients with MS after the time of diagnosis when compared with controls, but was not significant in men diagnosed after 2007 and women diagnosed after 2002. Lower income development was found in patients with MS starting at 3 years after diagnosis.

The model used in the study was not adjusted for the level of disability measured on the Expanded Disability Status Scale, which could have affected the results of income measurements.

“Our study shows that [patients with MS] have a lower income development compared to matched controls. This is especially evident for men, who lose income at a younger age and earlier in the disease course than women,” the authors concluded. Future studies should focus on how social determinants can affect income development in this cohort.

References

1. Høgset A, Simonsen CS, Flemmen HØ, et al. Differences in income growth between people with multiple sclerosis and controls: a Norwegian cohort study. Euro J Neurol. 2026;33(6):e70638. doi:10.1111/ene.70638
2. Signs of MS may start five years before diagnosis. MS International Federation. Updated September 2021. Accessed May 28, 2026. https://www.msif.org/news/2018/08/26/signs-of-ms-may-start-five-years-before-diagnosis/