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Cost-of-illness trajectories among people with multiple sclerosis by comorbidity: A register-based prospective study in Sweden

BACKGROUND: Comorbidities are common among people with multiple sclerosis (PwMS); yet, their impact on the cost-of-illness (COI) in MS is unknown. OBJECTIVE: Explore the heterogeneity in COI trajectories among newly diagnosed PwMS in relation to type of comorbidity. METHODS: A nationwide longitudina...

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Detalles Bibliográficos
Autores principales: Bütepage, Greta, Esawi, Ahmed, Alexanderson, Kristina, Friberg, Emilie, Murley, Chantelle, Hillert, Jan, Karampampa, Korinna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7585903/
https://www.ncbi.nlm.nih.gov/pubmed/33149932
http://dx.doi.org/10.1177/2055217320968597
Descripción
Sumario:BACKGROUND: Comorbidities are common among people with multiple sclerosis (PwMS); yet, their impact on the cost-of-illness (COI) in MS is unknown. OBJECTIVE: Explore the heterogeneity in COI trajectories among newly diagnosed PwMS in relation to type of comorbidity. METHODS: A nationwide longitudinal cohort study, using prospectively collected Swedish register data for seven years. The COI/year of 639 PwMS diagnosed in 2006, when aged 25–60, was estimated until 2013. Using healthcare data, PwMS were categorised into six comorbidity groups: ocular; cardiovascular, genitourinary or cancer disease; musculoskeletal; mental; neurological other than MS; and injuries. One group of PwMS without comorbidity was also created. Group-based trajectory modelling was applied, examining different COI trajectories within each comorbidity group. RESULTS: Across the seven follow-up years, PwMS with mental comorbidities had the highest COI overall (€36,482). Four COI trajectories were identified within each comorbidity group; the largest trajectory had high healthcare costs and productivity losses (36.3%–59.6% of PwMS, across all comorbidity groups). 59.6% of PwMS with mental comorbidity had high healthcare costs and productivity losses. CONCLUSION: High COI and heterogeneity in COI trajectories could be partly explained by the presence of chronic comorbidities in the year around MS diagnosis, including the presence of mental comorbidity.