Elsevier

Value in Health

Volume 21, Issue 5, May 2018, Pages 590-595
Value in Health

Personal Income Before and After Diagnosis of Multiple Sclerosis

https://doi.org/10.1016/j.jval.2017.09.021Get rights and content
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Abstract

Background

Multiple sclerosis (MS) is associated with serious morbidity and labor force absenteeism, but little is known of the long-term impact of the disease on personal income.

Objectives

To assess long-term consequences of MS on personal salary and disposable income.

Methods

Patients with MS in Sweden were identified in a nationwide, disease-specific register and matched with general population controls. We assessed mean annual personal gross salary and disposable income each year before and after index (i.e., the MS diagnosis date) using data from national registers.

Results

The final sample consisted of 5,472 patients and 54,195 controls (mean age 39 years; 70% females). There was no significant difference in gross salary between patients and controls in any year within the pre-index period. In contrast, on average during follow-up post diagnosis, patients with MS had €5,130 less gross salary per year compared with controls, ranging from a loss of €2,430 the first year to €9,010 after 11 years. Within 10 years after index, 45% of patients had at least one record of zero gross salary, compared with 32% for controls. Mean annual disposable income was comparable between patients and controls across follow-up, with significant differences only at years 9 and 10 post-index.

Conclusions

We show that many patients with MS in Sweden lose their ability to support for themselves financially but still have a relatively high disposable income because of social transfers. Our findings underscore the detrimental impact of MS on affected patients and the considerable economic burden of disease to society.

Keywords

cost of illness
longitudinal studies
multiple sclerosis
sick leave
Social Security
Sweden

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Conflicts of interest: E. Landfeldt, A. Castelo-Branco, and A. Svedbom are consultants to Novartis through their employment at Mapi Group. E. Löfroth is an employee and shareholder of Novartis. A. Kavaliunas reports no conflicts of interest. J. Hillert has received honoraria for serving on advisory boards for BiogenIdec and Novartis; has received speaker’s fees from BiogenIdec, Merck-Serono, Bayer-Schering, Teva, and Sanofi-Aventis; and has served as investigator for projects sponsored by, or received unrestricted research support from, BiogenIdec, Merck-Serono, Teva, Novartis, and Bayer-Schering.