Costs of multiple sclerosis in Serbia

The value of economic studies for decision making in health care has been widely recognized. The aim of this study was to estimate the annual costs of multiple sclerosis (MS) in Serbia. This is a cross-sectional study in which data on resource consumption and work capacity, and health-related quality of life (HRQoL) in MS patients, at the Clinic of Neurology, UCCS in Belgrade, were collected. A total of 356 patients (mean age, 42 years), out of which 271 treated with interferon beta agents, and the remaining 85 untreated, participated in this study. Ninety eight percent were below retirement age, and out of these, 54 % were employed. Employment decreased rapidly with advancing disability; 66 % of patients with Expanded Disability Status Scale (EDSS) 0-3.5 were employed, 31 % of those with EDSS 4.0-6.5, and 11 % with EDSS 7.0 and above. All HRQoL domains included in the EQ-5D displayed disturbances for a large number of patients: pain/discomfort for 67 %, usual activities 61 %, mobility 64 %, anxiety and depression 72 % and self-care 21 %. Total annual costs for patients treated with DMTs were 8,860 EUR and for the untreated 9,519 EUR, increasing significantly with worsening disability. This study describes the burden of MS in Serbian patients and provides data that are important for development of health policies.