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The direct cost of patients with multiple sclerosis: a survey from Italian MS centres

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Abstract

Multiple sclerosis (MS) is a chronic progressive disease of the CNS causing disability and neurological symptoms that carry a substantial burden. Previous Italian studies appear outdated, and investigation on the burden of recently marketed drug treatments should provide further economic evidence for policy makers. The objective of the study was to investigate patterns of care, resource consumption and direct medical cost of MS, in the perspective of the public health-care provider. Ten MS experts from public centres extracted and reported data of all MS patients seen during 2009, using a detailed questionnaire. The data of 8,326 MS patients were analysed: the course was relapsing–remitting in 5,376 (62%), secondary progressive in 1,798 (23%) and primary progressive in 691 (9%); 461 (6%) had a clinically isolated syndrome. The EDSS score was 0–3.5 in 5,118 (61%) patients, 4–6.5 in 2,408 (29%) and 7–9.5 in 800 (10%). The average cost of diagnosis (N = 694) was 1,236 €/patient with large variations between centres due to the chosen diagnostic setting. The average direct medical cost for biological disease-modifying drugs (bio-DMD) was 10,444 €/patient/year (cost/patient by primary drug: 9,501 € for interferon (IFN)-beta1a-im; 8,553 € for IFN-beta1b; 11,255 € for IFN-beta1a-sc44; 9,883 € for IFN-beta1a-sc22; 8,174 € for glatiramer acetate (GA); 21,817 € for natalizumab) and 3,151 € for non-bio-DMD. The cost of diagnosis is largely influenced by care setting, due to local health-care provision patterns. The annual medical cost/patient is largely driven by the cost of drugs (89.2% of total); GA represents the least expensive bio-DMD in the Italian health-care setting.

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Acknowledgments

This study was funded by an unrestricted grant from Sanofi-Aventis, Italy. The authors wish to thank Ms. Anna D’Ausilio for support in data gathering and Ms. Ilaria Piroddi for secretarial assistance.

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Authors and Affiliations

  1. PBE Consulting srl, Vicolo Stella 6, 37121, Verona, Italy

    Berto P

  2. Department of Neurological and Psychiatric Sciences, Firenze University, Firenze, Italy

    Amato MP

  3. MS Center IRCCS Neuromed, Pozzilli, Italy

    Bellantonio P

  4. Department of Neurology, MS Center, San Bortolo Hospital, Vicenza, Italy

    Bortolon F

  5. Department of Neurosciences, MS Center, Torino University, Torino, Italy

    Cavalla P

  6. Department of Neurology, Ospedale Cardarelli, Napoli, Italy

    Florio C

  7. Department of Neuroscience and Imaging, MS Center, “G. d’Annunzio” University, Chieti, Italy

    Lugaresi A

  8. Department of Neurology, Ospedale Civile, Fidenza, Italy

    Montanari E

  9. MS Center, Ospedali Riuniti, Bergamo, Italy

    Rottoli M

  10. Department of Neurological and Psychological Sciences, Bari University, Bari, Italy

    Simone IL

  11. MS Center, S. Antonio Abate Hospital, Gallarate, Italy

    Zaffaroni M

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  1. Berto P
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  2. Amato MP
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  8. Montanari E
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Correspondence to Berto P.

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P, B., MP, A., P, B. et al. The direct cost of patients with multiple sclerosis: a survey from Italian MS centres. Neurol Sci 32, 1035–1041 (2011). https://doi.org/10.1007/s10072-011-0578-4

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  • DOI: https://doi.org/10.1007/s10072-011-0578-4

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