Uso di database amministrativi per la rilevazione di consumo di risorse e spesa per pazienti affetti da sclerosi multipla nella Regione Piemonte

Abstract

Multiple Sclerosis (MS) is a chronic and disabling disease characterized by demyelination of the central nervous system, which can lead to physical and cognitive impairment. The literature on MS cost-of-illness shows that (i) cost per patient is rather high; (ii) informal care and loss of productivity are the major cost components; (iii) health care costs have been showing a steady increase, mostly due to high costs of immunomodulator drugs launched into the market in the last fifteen years.

The objective of this research is to estimate health resources consumption and costs of patients suffering from MS in Piedmont Region relying on administrative databases, that include information on drugs, outpatient and inpatient services consumed and covered by the Regional Government to patients affected by MS.

Databases show (i) in 2008 a number of 109.9 patients per 100,000 population, (ii) a cost per patient of €6,103, with a 67% drugs incidence, (iii) a huge and significant decrease in costs from the younger to the elderly population, (iv) a small but statistically significant impact of co-morbidities on unit costs, and (v) a very costly proximity to death.

Despite its limitations — e.g. database incompleteness, which did not allow us covering all health care services — this study shows that resource use and cost analysis may rely on administrative databases, thus avoiding (or integrating) prospective studies, which may be long and costly.