The economics of multiple sclerosis - Distribution of costs and relationship to disease severity

The introduction of expensive disease-modifying agents for the treatment of multiple sclerosis (MS) has created the potential for patients with MS to become higher contributors to healthcare spending. In an attempt to make fo rmulary and reimbursement choices for these agents, decision-makers may loo k to the literature for guidance. This critical review attempts to decipher a consistent message from the available economic literature regarding the relationship between disease severity and cost in MS. In the 2 studies that have examined MS disease severity, a positive correlation with total (dire ct and indirect) cost, indirect cost and some, if not all, components of di rect cost was reported. In studies taking the societal perspective, the maj ority of total costs were indirect. This paper documents the high burden of MS on society and serves to guide the decision-maker in interpreting the M S economic literature such that this information can be optimally utilised to make informed resource allocation decisions.