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Burden of disease in multiple sclerosis patients with spasticity in Germany: mobility improvement study (Move I)

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Abstract

Objectives

To describe the current management patterns of multiple sclerosis (MS) patients with spasticity in Germany and the impact of MS spasticity on quality of life (QoL) and associated costs.

Methods

Non-interventional, multicentre, cross-sectional and retrospective burden-of-disease study including 414 MS patients with spasticity (age from 25 to 80 years) from 42 clinical practices across Germany. All patients were diagnosed with MS-related spasticity based on neurological examination at least 12 months before inclusion in the study. Three different forms were completed on different aspects of the disease: the patient questionnaire, the chart documentation form and the physician questionnaire.

Results

Mild, moderate and severe spasticity were found in 27.3, 44.0 and 28.7 % of patients, respectively. Associated symptoms and QoL scores were worse in patients with higher degrees of spasticity. In particular, higher mean scores for sleep impairment (mild vs. severe, 2.1 vs. 4.3), mean spasm count (3/day vs. 10.1/day), mean WEIMuS fatigue score (15.8 vs. 19.8), increased walking time (9.6 vs. 20.2 s) and lower mean QoL scores (MSQoL-54 physical subscale, 54.9 vs. 39.5; EQ-5D, 0.60 vs. 0.30) were reported in patients with severe spasticity in comparison to patients with mild spasticity. Patient management mainly comprised physiotherapy (mild vs. severe, 65.5 vs. 85.7 %) and medication (84.2 vs. 64.8 %) with baclofen. The average cost for patients with mild spasticity was €2,268/year, increasing to €8,688/patient/year for patients with severe spasticity. The health insurance costs showed the same trend.

Conclusions

MS patients with spasticity suffer a significant burden because of resulting disabilities and reduced QoL, especially in cases of severe spasticity. Moreover, spasticity causes high costs that increase with increasing severity.

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Acknowledgments

The MOVE 1 study was supported by Almirall Hermal GmbH, Reinbek, Germany.

Conflict of interest

PF has received speaker’s fees and honoraria from Almirall Hermal GmbH, Bayer, Biogen Idec, Sanofi-Aventis, Merck-Serono, Novartis and Teva. None resulted in a possible conflict of interest. TH has received lecture fees and consultancy fees from Bayer-Schering, Biogen Idec, Sanofi-Aventis, Merck-Serono and TEVA, with no conflict of interest. UKZ has received speaker’s fees and honoraria from Bayer, Biogen Idec, Sanofi-Aventis, Merck-Serono, Novartis and Teva. None resulted in a possible conflict of interest.

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Authors and Affiliations

  1. Center of Neurology, University of Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany

    Uwe K. Zettl

  2. Rehabilitation centre for Neurology-Geriatrics-Urology, PASSAUER WOLF Reha-Centre Nittenau, Eichendorffstr. 21, 93149, Nittenau, Germany

    Thomas Henze

  3. Medical Affairs, Almirall Hermal GmbH, Scholtzstrasse 3, 21465, Reinbek, Germany

    Ute Essner

  4. Neurological Rehabilitation Centre Quellenhof Bad Wildbad, Kuranlagenallee 2, 75323, Bad Wildbad, Germany

    Peter Flachenecker

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Zettl, U.K., Henze, T., Essner, U. et al. Burden of disease in multiple sclerosis patients with spasticity in Germany: mobility improvement study (Move I). Eur J Health Econ 15, 953–966 (2014). https://doi.org/10.1007/s10198-013-0537-5

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