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[Cost of multiple sclerosis in France]
A Fromont1, M-N Lehanneur2, F Rollot3
1Service de neurologie, CHU de Dijon, 3, rue du Faubourg-Raines, 21000 Dijon, France; EA 4184, centre d'épidémiologie des populations, 1, boulevard Jeanne-d'Arc, BP 1542, 21079 Dijon, France.
Insights
Multiple sclerosis (MS) costs French healthcare over €469 million annually, with significant regional variations. The economic burden, including indirect costs, is substantial, comparable to HIV.
Area of Science:
- Neurology
- Health Economics
Context:
- Multiple sclerosis (MS) is a chronic condition designated as a long-term disease (ALD) in France.
- The French national health insurance fund (CNAMTS) covers healthcare costs for 87% of the population.
- This study analyzes the economic impact of MS within the CNAMTS-insured population in 2004.
Purpose:
- To evaluate the direct and indirect medical costs associated with multiple sclerosis in France.
- To determine the cost per patient and per expenditure item for MS.
- To analyze cost variations across French regions and over the disease's progression.
Summary:
- In 2004, 49,413 MS patients incurred direct costs of €469.7 million (€9,506 per patient).
- Expenditures included treatments (44.5%), hospitalization (27.9%), and nursing care (5.8%).
- Indirect costs were estimated at €116 million, with disability pensions and daily allowances impacting numerous patients.
Impact:
- MS imposes a significant economic burden on the French healthcare system, comparable to HIV.
- Costs escalate significantly in the final year of life and vary regionally.
- Understanding these costs informs resource allocation and healthcare policy for chronic diseases.
Abstract:
Multiple sclerosis (MS) is one of the 30 chronic conditions specifically listed by the French healthcare system as a long-term disease (affections de longue durée [ALD]) for which the main health insurance fund (Caisse nationale d'assurance maladie des travailleurs salariés [CNAMTS]) provides full (100%) coverage of healthcare costs. The CNAMTS insures 87% of the French population (52,359,912 of the 60,028,292 inhabitants). The objectives of this study were to evaluate the direct and indirect medical costs of MS among the entire population insured by the CNAMTS in France in 2004. The CNAMTS provided us with access to the ALD database of patients with MS that contains different MS-related expenditures made in 2004. We calculated the overall direct and indirect cost of MS and the cost per patient and per item of expenditure. In 2004, 49,413 patients were registered on the ALD list for MS. Direct cost for MS patients was 469,719,967 €. The direct cost per patient and per year was 9,506 € with variations between regions (French administrative divisions) ranging from 10,800 € in northeastern France (Champagne-Ardenne) to 8,217 € in western France (Pays de la Loire). The different items of expenditure were treatments (44.5%), hospitalization (27.9%), nursing care (5.8%), physiotherapy (5.7%), transport (4%), biology (1.1%), and other (1.5%). During the course of the disease, the overall cost of MS increased slowly during the first 15 years (from 8,000 to 11,000 €), but dramatically the last year of life (23,410 €). The costs of immunomodulator treatments were higher during the first six years after registration on the ALD list. Conversely, physiotherapy costs increased linearly with time during the course of MS. Indirect costs were an estimated 116 million euros in 2004. A disability pension (8,918 € per patient) was perceived by 9,430 patients (19.1%) and a daily allowance (3,317 € per patient) by 9,894 patients (20%). In France, MS has an important economic impact, comparable to human immunodeficiency virus infection.
