Prevalence and economic burden of major comorbidities in multiple sclerosis

• Published in: European journal of public health 2021-10, Vol.31 (Supplement_3)
• Main Authors: Ponzio, M, Borreli, P, Monti, MC, Amicizia, D, Perotti, P, Silva, S, Ansaldi, F, Mallucci, G, Bergamaschi, R, Montomoli, C
• Format: Article
• Language: English
• Subjects: Algorithms; Anxiety; Autoimmune diseases; Cancer; Cardiovascular disease; Cardiovascular diseases; Cerebrovascular diseases; Chronic illnesses; Comorbidity; Connective tissue diseases; Connective tissues; Coronary artery disease; Cost control; Diabetes; Diabetes mellitus; Economics; Health care; Health care expenditures; Health services; Heart diseases; HIV; Human immunodeficiency virus; Hyperlipidemia; Hypertension; Ischemia; Leukemia; Lymphoma; Mental depression; Multiple sclerosis; Public health; Renal failure; Vascular diseases
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/ckab165.204

Background Although comorbidity is important in Multiple Sclerosis (MS), few validated methods for its assessment exist. Our aim is to estimate the prevalence and economic burden of major comorbidities in people with MS (pwMS) in two Northern Italy study areas (Pavia, PV and Genoa, GE), using routinely collected healthcare data. Methods We estimated prevalence of comorbid conditions in pwMS in the period 2012-2017. Anxiety, depression, cancer, leukemia, lymphoma, hypertension, heart disease, cerebrovascular diseases, vascular diseases, ischemic stroke, hyperlipidaemia, bronchopathy, diabetes, gastropathy, gastric ulcer, autoimmune diseases, chronic renal failure, connective tissue diseases and HIV/AIDS were identified by a specific algorithm currently used for monitoring prevalence of chronic diseases by Italian Local Health Authorities (BDA system). Direct healthcare costs were defined by regional and governmental contracts; the aggregated healthcare expenditure was compared between pwMS with/without comorbidities. Results The MS cases identified were 2983, 2035 in GE and 948 in PV. 55.6% of pwMS had at least one comorbidity (50.6% GE and 66.5% PV, p < 0.001). The most prevalent comorbidities were: depression (32.9%), hypertension (18.0%), cancer (10.9%), heart disease (7.8%), cerebrovascular diseases (7.0%) and hyperlipidaemia (6.1%). Comorbidity ranking was similar in the two provinces, although we observed significant differences considering specific prevalence rates. The mean direct healthcare costs of MS were substantially higher for individuals with comorbidity (36,463 €vs 26,284 €, p < 0.001), showing 39% of additive costs. Conclusions Our study provides evidence of the burden of comorbidities in MS. Comorbidity is common in MS and produce additive costs. Key messages The use of administrative data for tracking the MS comorbidity could help knowledge gaps. When additivity situation is involved, preventive policies could lead to monetary savings.