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Economic impact of multiple sclerosis in Italy: focus on rehabilitation costs

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The study estimates the cost of multiple sclerosis (MS) in Italy quantifying the impact of the rehabilitation on cost of illness. Patients with MS were enrolled at MS clinical centres, in rehabilitation units and among members with MS of the Italian MS Society across the Italy. The MS costs were captured with a questionnaire and were estimated taking into account both healthcare and non-healthcare costs as well as the productivity losses. Mean total annual costs per patients were €37,948, increasing for different disease severity: from €22,750 at an EDSS score of 0–3 to €63,047 at an EDSS score equal to or more than 7. €3,418 was due to rehabilitation (about 26.7 % of direct healthcare costs) and of these 44 % was attributable to admission to rehabilitation. The multivariate analysis showed a consistent trend toward increased total cost with progressive severity of MS, with presence of relapses, while the total cost decreases with a better quality of life. The burden increases as the MS becomes more severe and with relapse occurrence, moreover we observed high costs due to admission to rehabilitation suggesting that different rehabilitation setting might be considered to reduce the financial burden and increase the quality of life for person with MS.

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  1. Pugliatti M, RosatiG Carton H, Riise T, Drulovic J, Vecsei L, Milanov I (2006) The epidemiology of multiple sclerosis in Europe. Eur J Neurol 13:700–722

    Article  CAS  PubMed  Google Scholar 

  2. Atlas of MS (2013) Accessed Oct 2013

  3. Olesen J, Gustavsson A, Svensson M, Wittchen HU, Jonsson B (2012) The economic cost of brain disorders in Europe. Eur J Neurol 19:155–162

    Article  CAS  PubMed  Google Scholar 

  4. Naci H, Fleurence R, Birt J, Duhig A (2010) Economic burden of multiple sclerosis. A systematic review of the literature. Pharmacoeconomics 28(5):363–379

    Article  PubMed  Google Scholar 

  5. Amato MP, Battaglia MA, Caputo D, Fattore G, Gerzeli S, Pitaro M, Reggio A, Trojano M, for the Mu. S. I. C. Study Group (2002) The costs of multiple sclerosis: a cross-sectional, multi center cost-of-illness study in Italy. J Neurol 249:152–163

    Article  PubMed  Google Scholar 

  6. Karampampa K, Gustavsson A, Miltenburger C, Teruzzi C, Fattore G (2012) Treatment experience, burden and unmet needs (TRIBUNE) in MS study: results from Italy. Mult Scler J 18(Suppl 2):29–34

    Article  Google Scholar 

  7. Kobelt G, Berg J, Lindgren P, Battaglia MA, Lucioni C, Uccelli A (2006) Costs and quality of life of multiple sclerosis in Italy. Eur J Health Econ 7:S45–S54

    Article  PubMed  Google Scholar 

  8. Vosoughi R, Freedman MS (2010) Therapy of MS. Clin Neurol Neurosurg 112(5):365–385

    Article  PubMed  Google Scholar 

  9. Beer S, Khan F, Kesselring J (2012) Rehabilitation interventions in multiple sclerosis: an overview. J Neurol 259:1994–2008

    Article  PubMed  Google Scholar 

  10. Kobelt G, Berg J, Lindgren P, Jönsson B (2006) Costs and quality of life in multiple sclerosis in Europe: method of assessment and analysis. Eur J Health Econ 7(Suppl 2):S5–S13

    Article  PubMed  Google Scholar 

  11. The EuroQoL Group (1990) EuroQol—a new facility for the measurement of health-related quality of life. Health Policy 16:199–208

    Article  Google Scholar 

  12. Dolan P (1997) Modeling valuations for EuroQol health states. Med Care 35(11):1095–1108

    Article  CAS  PubMed  Google Scholar 

  13. Posnett J, Jan S (1996) Indirect cost in economic evaluation: the opportunity cost of unpaid inputs. Health Econ 5:13–23

    Article  CAS  PubMed  Google Scholar 

  14. Koopmanschap MA, Rutten FF (1993) Indirect costs in economic studies. Pharmacoeconomics 4:446–454

    Article  CAS  PubMed  Google Scholar 

  15. Kind P, Hardman G and Macran S (1999) UK population norms for EQ-5D. York Centre for Health Economics, Discussion Paper, University of York

  16. McCrone P, Heslin M, Knapp M, Bull P, Thompson A (2009) Multiple sclerosis in the UK: service use, costs, quality of life and disability. Pharmacoeconomics 26(10):847–860 (Erratum in: Pharmacoeconomics 27(4):354)

    Article  Google Scholar 

  17. Patwardahn MB, Mathcar DB, Samsa GP, McCrory DC, Williams DG, Li TT (2005) Cost of multiple sclerosis by level of disability; a review of literature. Mult Scler 11:232–239

    Article  Google Scholar 

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We wish to thank the people with MS who participated in this study and the trained personnel for their assistance with data collection. This study was supported by the Italian Minister of Public Health (RFPS-2007-6-659211)

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Correspondence to Michela Ponzio.

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Ponzio, M., Gerzeli, S., Brichetto, G. et al. Economic impact of multiple sclerosis in Italy: focus on rehabilitation costs. Neurol Sci 36, 227–234 (2015).

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