Burden of disease in multiple sclerosis patients with spasticity in Germany: mobility improvement study (Move I)

• Published in: The European journal of health economics Vol. 15; no. 9; pp. 953 - 966
• Main Authors: Zettl, Uwe K., Henze, Thomas, Essner, Ute, Flachenecker, Peter
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer 01-12-2014; Springer Berlin Heidelberg
• Subjects: Adult; Aged; Aged, 80 and over; Cost of Illness; Cross-Sectional Studies; Direct costs; Disabilities; Economic costs; Economic Policy; Fatigue; Female; Germany; Health Care Management; Health Economics; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Mobility Limitation; Multiple sclerosis; Multiple Sclerosis - complications; Multiple Sclerosis - economics; Multiple Sclerosis - therapy; Muscle Spasticity - economics; Muscle Spasticity - etiology; Muscle Spasticity - therapy; Nervous system diseases; Original Paper; Pharmacoeconomics and Health Outcomes; Physical therapy; Physicians; Public Finance; Public Health; Quality of Life; Questionnaires; Retrospective Studies; Severity of Illness Index; Germany; Spasticity; I1; Burden of disease; Multiple sclerosis; Cost; Quality of life
• ISSN: 1618-7598; 1618-7601
• DOI: 10.1007/s10198-013-0537-5

Objectives To describe the current management patterns of multiple sclerosis (MS) patients with spasticity in Germany and the impact of MS spasticity on quality of life (QoL) and associated costs. Methods Non-interventional, multicentre, cross-sectional and retrospective burden-of-disease study including 414 MS patients with spasticity (age from 25 to 80 years) from 42 clinical practices across Germany. All patients were diagnosed with MS-related spasticity based on neurological examination at least 12 months before inclusion in the study. Three different forms were completed on different aspects of the disease: the patient questionnaire, the chart documentation form and the physician questionnaire. Results Mild, moderate and severe spasticity were found in 27.3, 44.0 and 28.7 % of patients, respectively. Associated symptoms and QoL scores were worse in patients with higher degrees of spasticity. In particular, higher mean scores for sleep impairment (mild vs. severe, 2.1 vs. 4.3), mean spasm count (3/day vs. 10.1/day), mean WEIMuS fatigue score (15.8 vs. 19.8), increased walking time (9.6 vs. 20.2 s) and lower mean QoL scores (MSQoL-54 physical subscale, 54.9 vs. 39.5; EQ-5D, 0.60 vs. 0.30) were reported in patients with severe spasticity in comparison to patients with mild spasticity. Patient management mainly comprised physiotherapy (mild vs. severe, 65.5 vs. 85.7 %) and medication (84.2 vs. 64.8 %) with baclofen. The average cost for patients with mild spasticity was €2,268/year, increasing to €8,688/patient/year for patients with severe spasticity. The health insurance costs showed the same trend. Conclusions MS patients with spasticity suffer a significant burden because of resulting disabilities and reduced QoL, especially in cases of severe spasticity. Moreover, spasticity causes high costs that increase with increasing severity.