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The prevalence of MS in the United States: A population-based estimate using health claims data
Mitchell T Wallin1, William J Culpepper2, Jonathan D Campbell2
1From the Department of Veterans Affairs Multiple Sclerosis Center of Excellence (M.T.W., W.J.C.); Georgetown University School of Medicine (M.T.W.), Washington, DC; University of Maryland (W.J.C.), Baltimore; University of Colorado (J.D.C., P.D.), Aurora; Stanford University School of Medicine (L.M.N., B.T.), CA; Southern California Permanente Medical Group (A.L.-G., L.H.C.), Pasadena; Departments of Internal Medicine and Community Health Sciences (R.A.M.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; University of Alabama at Birmingham (G.R.C.); McKing Consulting Corp (W.E.K., L.W.), Atlanta, GA; Faculty of Medicine (Neurology) and Centre for Brain Health (H.T.), University of British Columbia, Vancouver, Canada; Brown University (S.L.B.), Providence, RI; and National Multiple Sclerosis Society (N.G.L.), New York, NY. mitchell.wallin@va.gov.
Objective:
To generate a national multiple sclerosis (MS) prevalence estimate for the United States by applying a validated algorithm to multiple administrative health claims (AHC) datasets.
Methods:
A validated algorithm was applied to private, military, and public AHC datasets to identify adult cases of MS between 2008 and 2010. In each dataset, we determined the 3-year cumulative prevalence overall and stratified by age, sex, and census region. We applied insurance-specific and stratum-specific estimates to the 2010 US Census data and pooled the findings to calculate the 2010 prevalence of MS in the United States cumulated over 3 years. We also estimated the 2010 prevalence cumulated over 10 years using 2 models and extrapolated our estimate to 2017.
Results:
The estimated 2010 prevalence of MS in the US adult population cumulated over 10 years was 309.2 per 100,000 (95% confidence interval [CI] 308.1-310.1), representing 727,344 cases. During the same time period, the MS prevalence was 450.1 per 100,000 (95% CI 448.1-451.6) for women and 159.7 (95% CI 158.7-160.6) for men (female:male ratio 2.8). The estimated 2010 prevalence of MS was highest in the 55- to 64-year age group. A US north-south decreasing prevalence gradient was identified. The estimated MS prevalence is also presented for 2017.
Conclusion:
The estimated US national MS prevalence for 2010 is the highest reported to date and provides evidence that the north-south gradient persists. Our rigorous algorithm-based approach to estimating prevalence is efficient and has the potential to be used for other chronic neurologic conditions.
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