The economic impact of multiple sclerosis
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The Economic Impact of MULTIPLE SCLEROSIS. Who needs to know?. Why do they need to know ?. a: Policy Makers. Resource Allocation. b: Special interest groups - patients, charities. Influence resource allocation. c: Healthcare providers. Administer government policy .

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The economic impact of multiple sclerosis l.jpg

The Economic ImpactofMULTIPLE SCLEROSIS


Why should we measure costs l.jpg

Who needs to know?

Why do they need to know?

a:PolicyMakers

ResourceAllocation

b:Special interest groups - patients, charities

Influence resource allocation.

c:Healthcare providers

Administer government policy.

d:Drug and technology developers

Evaluate government effectiveness.

e:Citizens

Research investment priorities.

Why should we measure costs?

“There are a lot of things I could use to help me but it would cost me too much. I only have the pension so I do what I can myself”


What happens if we don t measure costs someone else does l.jpg

“The study showed that preventative treatment with interferon beta in patients with multiple sclerosismay not be justified from a health-economic perspective, although interferon beta is associated with an improved effectiveness compared to no preventative treatment.”

Nuijten MJ, Hutton J, Cost-effectiveness analysis of interferon beta in multiple sclerosis: a Markov process analysis. Value Health 2002 5(1): 44-54

What happens if we don’t measure costs? ………… someone else does


What costs are measured in cost of illness studies l.jpg
What costs are measured in interferon beta in patients with multiple sclerosis‘cost of illness’ studies:

Borne by government

publicpayerperspective

Borne by society as a whole

societal perspective

“Our out-of-pocket medical expenses last year were something like $3,000”


But what about the costs to people with ms and their families l.jpg
But what about the costs to people with MS and their families?

“Although we keep a very brave face, and have changed our lifestyle, we are at a stage where we can’t cut costs any more”.

“I feel uncomfortable spending money on myself, even on little things, when I am not earning and things are so tight …. I feel awful that my children are being denied”


Summary l.jpg
Summary families?

  • Look at the costs involved in MS

  • Compare costs of MS in Australia, UK, Germany

  • Sweden

  • Discuss our pilot study on extra costs borne by people with MS and their families

  • Examine burden of care implications

“I would use house cleaning, food preparation, relationship counselling and legal advice - if I could afford them!”


What are the costs of ms made up of l.jpg
What are the costs of MS made up of? families?

DIRECTCOSTS

INFORMALCOSTS

INDIRECTCOSTS

INTANGIBLECOSTS

TOTALCOSTS

+

+

+

=

Inpatient care.

Ambulatory care.

Drugs.

Services:

- home care

- child care

- day care.

Adaptations.

Careprovidedbyfamilyandfriends.

Sickleave.

Earlyretirement.

Prematuremortality.

Duetopain, grief, anxietyandsocialhandicap.

“My Government core package includes personal care, housework, gardening, meals on wheels 5 days a week. On weekends I must rely on neighbours, or go to a café, or go hungry!”


What are the costs of ms made up of8 l.jpg
What are the costs of MS made up of? families?

DIRECTCOSTS

INFORMAL COSTS

INDIRECT COSTS

INTANGIBLE COSTS

TOTAL COSTS

+

+

+

=

IMPACTQUALITYOFLIFE

GOVERNMENT

FAMILY

=

INCOME

LIFESTYLE

“MS has taken away our dreams, hopes & wishes. To stress and not do a weekly food shop because the money has gone on other things, mainly medical costs, is disgraceful and very belittling!”


International comparisons uk 1999 germany 1999 sweden 1998 australia 2000 l.jpg
International comparisons, families?UK (1999), Germany (1999), Sweden (1998), Australia (2000)

Challenges in making comparisons between

International studies:

  • Differences in cost calculation methods between studies (although standards are being developed).

  • Differences indatesofstudies- new therapies (eg interferon) - inflation (Adjusted to CPI 2002 (ABS)

  • ExchangeratesvBuyingpower …AdjustedtoPPPUS$ (OECD)

  • Dataacrosscountriesuse$purchasepower.


Indirect costs loss of productivity income l.jpg
INDIRECT COSTS: families?Loss of productivity (income)

PPP. (US$)

“It is difficult when you do not know what the future holds and how it will impact on you. This is what I find hard. What is in store for me and my partner?”


Direct costs hospitalisation ambulatory care drugs social services adaptations l.jpg
DIRECT COSTS: families?Hospitalisation; ambulatory care; drugs; social services; adaptations

PPP ($US)

“How do you embrace all life has to offer in case you cannot in the future and yet save/plan, in case life becomes less than it is now?”


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DIRECT COSTS per PwMS families?UK v Germany v Sweden

(average total patients)

PPP ($US)

“My financial position in the future is of enormous concern… fatigue, finances and career are my greatest concerns.”


Slide13 l.jpg

INFORMAL families?COSTS

Care provided by family & friends

PPP ($US)

“I really hate what it has done to me & my family. Loss of self-esteem, uselessness, not pulling your weight - are everyday feelings. It is very wearing.”


Economic distress cutbacks on expenditure l.jpg
Economic Distress families?Cutbacks on Expenditure

ITEM PERCENTAGE REPORTING CUTBACKS

Food 32.7

Clothing 62.6

Entertainment 73.8

Restaurant Meals 71.7

Holidays 76.6

Children’s Activities 34.0

School Fees 25.0

Visits to friends/ family 39.6

Gifts 59.4

“I think chronic illness is isolating - however the consequent poverty maximises it!”


Economic distress cutbacks on expenditure15 l.jpg
Economic Distress families?Cutbacks on Expenditure

ITEM PERCENTAGE REPORTING CUTBACKS

Computers, Software 52.9

Electrical Goods 50.9

Replacing Furniture 59.0

Hairdressing/ Toiletries 41.9

Books/ Magazines 49.1

Source: M De Judicibus

Economic Impact of MS

Australian Study - Deakin University 2000

Attending Sporting Events 49.5

Tobacco 22.7

Alcohol 27.4

“We have not had a holiday in 10 years. I buy my clothes at op shops. When we have to go somewhere special, my husband borrows the boys shoes.”


Economic pressure scale 0 50 l.jpg
Economic Pressure Scale (0-50) families?

Source: M De Judicibus

Economic Impact of MS

Australian Study - Deakin University 2000

SCORE

Male 18.3

Female 19.4

Urban 17.8

Rural 22.1

TOTAL 19.2

O = ‘no pressure’ 50 = extreme pressure

“The financial burden has been crippling … harder to cope with than the disease”


Slide17 l.jpg

Conclusions families?

  • Calculating costs: vital

  • Insights internationally - countries do it differently

  • Studies must consider the ‘MS penalty’ - out of pocket expenses.

  • Quality of life costs- people with MS - the whole family.

  • Costs to the Community- costs v research.

  • Data across countries use $ purchase power

“You are reminded of the financial loss of MS every time you visit your friends - things you aspire to but can no longer think about. It is like a constant kick in the teeth!”


Slide18 l.jpg

Acknowledgements families?

  • Dr. K Tansourns (Neurosciences Victoria)

  • Dr. M De Judicibus (Deakin University)

  • Quotes: Participants in “The Financial Impact of MS Study Ausralia”

“We Australians are extremely fortunate in this level of medical care - in this country. The MS Society is an excellent source of support at all times!”


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