Direct costs of relapses in patients with relapsing-remitting multiple sclerosis

Introduction: Effective treatments that reduce relapses can diminish the impact on MS costs in the long-term. This study aims to estimate direct costs of RRMS relapses in Catalonia (Spanish region). Methods: Multi-centre, prospective, cross-sectional observational study with retrospective data collection. Estimated costs: disease-modifying therapies (DMTs) and symptoms treatments, use of hospital and ambulatory resources, technical aids, transport and paid caregivers from the National Health System (NHS) and global perspectives. Results: One hundered and forty (140) suitable patients were included to estimate direct costs (mean [SD] age: 40.7 [10] years; females: 71.5%; low EDSS score at relapse start: 77.5%). Mean total direct costs of relapse/patient were €4,541 (NHS) and €4,626 (global). A subanalysis was performed in patients with relapses lasting ≤90 days (100 patients), relapse total direct costs/patient were €4,989 (NHS) and €5,115 (global). Motor relapses presented a higher cost (a mean of €9,345/patient). Mean total direct cost/patient was higher when there was a DMT switch due to the relapse (€14,370 compared to €1,149), from a global perspective. Conclusion: Mean direct costs of RRMS relapse/patient in Catalonia were €4,989 and €5,115 for NHS and global perspectives, respectively. The type of relapse and switching the DMT due to the relapse were associated with an increase in direct costs. Resumen: Introducción: Los tratamientos que logran reducir los brotes en la esclerosis múltiple (EM) también pueden disminuir el coste de la enfermedad a largo plazo. El propósito de este estudio es realizar una estimación de los costes directos relacionados con la EM remitente-recurrente (EMRR) en Cataluña. Métodos: Hemos realizado un estudio observacional, transversal, prospectivo y multicéntrico en el que hemos recogido los datos de forma retrospectiva. Para calcular los costes directos, consideramos los costes derivados del uso de fármacos modificadores de la enfermedad (FME) y tratamientos sintomáticos, recursos hospitalarios y ambulatorios, ayudas técnicas, transporte y cuidadores remunerados, tanto desde la perspectiva del sistema nacional de salud (SNS) como desde una perspectiva global. Resultados: Recogimos datos de 140 pacientes cuya edad media (DE) era de 40,7 (10) años; de ellos, el 71,5% eran mujeres y 77,5% presentaron una puntuación baja en la EDSS al comienzo de los brotes. Los costes directos medios de los brotes fueron de 4541€ (SNS) y de 46