ECONOMIC-EVALUATION OF MULTIPLE-SCLEROSIS IN THE UK, GERMANY AND FRANCE

A cross-sectional cost-of-care study was performed to assess the econo mic burden of multiple sclerosis (MS) in France, Germany and the UK. P atients were stratified into 3 groups according to the Expanded Disabi lity Severity Scale (EDSS): stages I, II and III, corresponding to mil d (EDSS 1.0 to 3.5), moderate (EDSS 4.0 to 6.0) and severe (EDSS 6.5 t o 8.0) MS, respectively. 90 patients with MS and 30 non-MS control pat ients were recruited in each country. Control patients were matched to the patients with MS on the basis of age and gender. Demographic, cli nical and economic data during the 3-month period prior to entry were collected in patient interviews. Total costs included actual expenditu res, such as direct medical and non-medical costs, as well as indirect costs. From the societal perspective, the total cost of MS for 3 mont hs was estimated at $US 1928 $US3941 and $US5678 in France, $US2772, $ US2056 and $US5701 in Germany, and $US5125, $US6751 and $US14 622 in t he UK, for stage I, II and III patients, respectively. The major medic al cost driver in the UK was outpatient consultations, whereas hospita lisations were the major component in Germany and France. The major co st in the UK arose from the dependence of patients with MS on caregive rs, which caused high non-medical, societal costs compared with France and Germany. From both the societal and hearth insurance perspectives in each country, costs for control patients were lower than those for stage I MS patients. MS represents a major financial burden on the in dividual, the family, health services and society, and these costs inc rease with MS progression.