Table 3.
Number and percentage of users of the respective resource, mean per person costsa with standard deviations (SDs) and 95% confidence intervals (CIs) for all of the people with multiple sclerosis (PwMS) and the population-based matched references, respectively, mean differences with 95% CIs between the PwMS and matched references, and the percentage of the mean costs among PwMS attributable to the excess, for each study year
PwMS (n = 1988) | Matched references (n = 7981) | Mean difference | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Users (n) | Users (%) | Mean (EUR) | SD | 95% CI | Users (n) | Users (%) | Mean (EUR) | SD | 95% CI | Mean (EUR) | 95% CI | p value | Percentage excessb | |
(a) Total costs | ||||||||||||||
Total costs | ||||||||||||||
Year −4 | 1530 | 77.0 | 8225 | 16,715 | 7490–8960 | 5926 | 74.3 | 6469 | 15,026 | 6139–6799 | 1756 | 1000–2512 | < 0.001 | 21.3 |
Year −3 | 1546 | 77.8 | 8575 | 17,044 | 7826–9325 | 5878 | 73.7 | 6491 | 15,135 | 6159–6823 | 2085 | 1321–2848 | < 0.001 | 24.3 |
Year −2 | 1593 | 80.1 | 9154 | 18,349 | 8347–9961 | 5937 | 74.4 | 6253 | 15,267 | 5918–6588 | 2901 | 2118–3683 | < 0.001 | 31.7 |
Year −1 | 1702 | 85.6 | 11,408 | 19,093 | 10,568–12,247 | 5923 | 74.2 | 6234 | 15,101 | 5903–6566 | 5173 | 4388–5958 | < 0.001 | 45.3 |
Year 0 | 1988 | 100.0 | 26,203 | 23,690 | 25,161–27,245 | 6000 | 75.2 | 6441 | 15,256 | 6106–6775 | 19,762 | 18,913–20,611 | < 0.001 | 75.4 |
Year +1 | 1963 | 98.7 | 27,814 | 24,216 | 26,749–28,879 | 6043 | 75.7 | 6742 | 15,779 | 6396–7088 | 21,072 | 20,199–21,946 | < 0.001 | 75.8 |
Year +2 | 1958 | 98.5 | 27,584 | 24,288 | 26,516–28653 | 6039 | 75.7 | 7306 | 16,656 | 6941–7672 | 20,278 | 19,372–21,183 | < 0.001 | 73.5 |
Year +3 | 1960 | 98.6 | 26,905 | 24,116 | 25,844–27966 | 6015 | 75.4 | 7966 | 17,832 | 7574–8357 | 18,939 | 17,994–19,885 | < 0.001 | 70.4 |
Year +4 | 1956 | 98.4 | 27,167 | 24,443 | 26,091–28242 | 6097 | 76.4 | 8448 | 18,121 | 8050–8845 | 18,719 | 17,759-19,679 | < 0.001 | 68.9 |
(b) Healthcare costs | ||||||||||||||
Total healthcare costs | ||||||||||||||
Year −4 | 1513 | 76.1 | 1121 | 3495 | 968–1275 | 5856 | 73.4 | 906 | 3138 | 837–974 | 216 | 58–374 | 0.007 | 19.3 |
Year −3 | 1525 | 76.7 | 1282 | 3247 | 1140–1425 | 5808 | 72.8 | 943 | 2801 | 882–1005 | 339 | 197–481 | < 0.001 | 26.4 |
Year −2 | 1578 | 79.4 | 1605 | 5540 | 1361–1848 | 5874 | 73.6 | 1000 | 3886 | 914–1085 | 605 | 395–815 | < 0.001 | 37.7 |
Year −1 | 1689 | 85.0 | 2272 | 4401 | 2078–2465 | 5867 | 73.5 | 1011 | 3291 | 939–1083 | 1261 | 1087–1435 | < 0.001 | 55.5 |
Year 0 | 1987 | 100.0 | 8870 | 7656 | 8533–9206 | 5932 | 74.3 | 1132 | 3433 | 1057–1207 | 7738 | 7512–7964 | < 0.001 | 87.2 |
Year +1 | 1962 | 98.7 | 10,312 | 8613 | 9933–10,691 | 5984 | 75.0 | 1202 | 3996 | 1115–1290 | 9110 | 8852–9368 | < 0.001 | 88.3 |
Year +2 | 1954 | 98.3 | 9527 | 8260 | 9164–9891 | 5983 | 75.0 | 1364 | 4673 | 1261–1466 | 8164 | 7890–8438 | < 0.001 | 85.7 |
Year +3 | 1955 | 98.3 | 8910 | 8417 | 8540–9280 | 5950 | 74.6 | 1423 | 5997 | 1292–1555 | 7487 | 7165–7809 | < 0.001 | 84.0 |
Year +4 | 1950 | 98.1 | 8347 | 8184 | 7987–8707 | 6023 | 75.5 | 1405 | 4831 | 1299–1511 | 6943 | 6665–7221 | < 0.001 | 83.2 |
Inpatient healthcare costs | ||||||||||||||
Year −4 | 190 | 9.6 | 534 | 2865 | 408–660 | 684 | 8.6 | 443 | 2332 | 392–494 | 91 | −30 to 211 | 0.139 | 17.0 |
Year −3 | 209 | 10.5 | 565 | 2355 | 462–669 | 694 | 8.7 | 418 | 1989 | 375–462 | 147 | 45–248 | 0.005 | 26.0 |
Year −2 | 207 | 10.4 | 707 | 4874 | 493–922 | 693 | 8.7 | 449 | 3230 | 378–520 | 258 | 80–436 | 0.004 | 36.5 |
Year −1 | 327 | 16.5 | 882 | 3116 | 745–1019 | 621 | 7.8 | 416 | 2495 | 362–471 | 465 | 336–594 | < 0.001 | 52.7 |
Year 0 | 729 | 36.7 | 2449 | 5739 | 2196–2701 | 706 | 8.9 | 483 | 2434 | 430–537 | 1966 | 1800–2131 | < 0.001 | 80.3 |
Year +1 | 353 | 17.8 | 1613 | 6161 | 1342–1884 | 650 | 8.1 | 508 | 3206 | 438–579 | 1105 | 909–1300 | < 0.001 | 68.5 |
Year +2 | 340 | 17.1 | 1591 | 5349 | 1356–1826 | 710 | 8.9 | 622 | 3859 | 538–707 | 969 | 762–1175 | < 0.001 | 60.9 |
Year +3 | 324 | 16.3 | 1459 | 5284 | 1226–1691 | 669 | 8.4 | 647 | 5162 | 533–760 | 812 | 557–1067 | < 0.001 | 55.7 |
Year +4 | 297 | 14.9 | 1280 | 4640 | 1075–1484 | 631 | 7.9 | 608 | 3703 | 527–690 | 671 | 479–863 | < 0.001 | 52.4 |
Specialised outpatient healthcare costs | ||||||||||||||
Year −4 | 685 | 34.5 | 313 | 727 | 281–345 | 2477 | 31.0 | 253 | 837 | 235–272 | 60 | 20–100 | 0.004 | 19.2 |
Year −3 | 762 | 38.3 | 389 | 827 | 353–426 | 2572 | 32.2 | 310 | 858 | 291–329 | 79 | 37–121 | < 0.001 | 20.3 |
Year −2 | 890 | 44.8 | 479 | 919 | 439–520 | 2738 | 34.3 | 333 | 859 | 314–352 | 146 | 103–189 | < 0.001 | 30.5 |
Year −1 | 1141 | 57.4 | 762 | 1263 | 706–818 | 2770 | 34.7 | 362 | 972 | 341–383 | 400 | 349–451 | < 0.001 | 52.5 |
Year 0 | 1950 | 98.1 | 2221 | 1622 | 2150–2292 | 3008 | 37.7 | 407 | 1019 | 385–429 | 1814 | 1757–1871 | < 0.001 | 81.7 |
Year +1 | 1840 | 92.6 | 1736 | 1703 | 1661–1811 | 3160 | 39.6 | 449 | 997 | 427–471 | 1287 | 1229–1345 | < 0.001 | 74.1 |
Year +2 | 1807 | 90.9 | 1620 | 1644 | 1548–1692 | 3221 | 40.4 | 482 | 1099 | 458–506 | 1138 | 1077–1198 | < 0.001 | 70.2 |
Year +3 | 1782 | 89.6 | 1617 | 1701 | 1542–1692 | 3268 | 41.0 | 503 | 1128 | 478–528 | 1114 | 1052–1176 | < 0.001 | 68.9 |
Year +4 | 1754 | 88.2 | 1678 | 1783 | 1600–1756 | 3280 | 41.1 | 533 | 1217 | 507–560 | 1145 | 1078–1211 | < 0.001 | 68.2 |
Drug costs | ||||||||||||||
Year −4 | 1339 | 67.4 | 275 | 1153 | 224–326 | 5078 | 63.6 | 209 | 987 | 188–231 | 65 | 15–116 | 0.011 | 23.6 |
Year −3 | 1287 | 64.7 | 328 | 1393 | 267–389 | 4843 | 60.7 | 215 | 1063 | 192–238 | 113 | 57–169 | < 0.001 | 34.5 |
Year −2 | 1313 | 66.1 | 418 | 1723 | 342–494 | 4901 | 61.4 | 218 | 1069 | 194–241 | 201 | 140–261 | < 0.001 | 48.1 |
Year −1 | 1397 | 70.3 | 628 | 2118 | 535–721 | 4875 | 61.1 | 232 | 1203 | 206–259 | 396 | 325–466 | < 0.001 | 63.1 |
Year 0 | 1830 | 92.1 | 4200 | 4549 | 4000–4400 | 4946 | 62.0 | 242 | 1301 | 213–270 | 3958 | 3843–4073 | < 0.001 | 94.2 |
Year +1 | 1830 | 92.1 | 6963 | 5911 | 6703–7223 | 5001 | 62.7 | 245 | 1328 | 216–274 | 6718 | 6576–6860 | < 0.001 | 96.5 |
Year +2 | 1804 | 90.7 | 6316 | 6173 | 6045–6588 | 4937 | 61.9 | 259 | 1408 | 228–290 | 6057 | 5908–6206 | < 0.001 | 95.9 |
Year +3 | 1785 | 89.8 | 5834 | 6327 | 5556–6113 | 4978 | 62.4 | 274 | 1783 | 235–313 | 5560 | 5401–5720 | < 0.001 | 95.3 |
Year +4 | 1747 | 87.9 | 5390 | 6412 | 5108–5672 | 5052 | 63.3 | 263 | 1473 | 230–295 | 5127 | 4972–5282 | < 0.001 | 95.1 |
(c) Productivity losses | ||||||||||||||
Total productivity losses | ||||||||||||||
Year −4 | 405 | 20.4 | 7104 | 15,328 | 6430–7778 | 1370 | 17.2 | 5563 | 13,763 | 5261–5865 | 1540 | 848–2233 | < 0.001 | 21.7 |
Year −3 | 406 | 20.4 | 7293 | 15,742 | 6601–7986 | 1322 | 16.6 | 5547 | 14,010 | 5240–5855 | 1746 | 1040–2452 | < 0.001 | 23.9 |
Year −2 | 425 | 21.4 | 7549 | 16,124 | 6840–8258 | 1256 | 15.7 | 5254 | 13,754 | 4952–5555 | 2296 | 1595–2996 | < 0.001 | 30.4 |
Year −1 | 530 | 26.7 | 9136 | 17,212 | 8379–9893 | 1229 | 15.4 | 5223 | 13,802 | 4921–5526 | 3913 | 3198–4627 | < 0.001 | 42.8 |
Year 0 | 987 | 49.7 | 17,333 | 20,680 | 16,423–18,243 | 1264 | 15.8 | 5309 | 13,859 | 5005–5613 | 12,024 | 11,265–12,784 | < 0.001 | 69.4 |
Year +1 | 903 | 45.4 | 17,502 | 21,396 | 16,561–18,443 | 1309 | 16.4 | 5540 | 14,156 | 5229–5850 | 11,962 | 11,183–12,742 | < 0.001 | 68.3 |
Year +2 | 921 | 46.3 | 18,057 | 21,665 | 17,104–19,010 | 1393 | 17.5 | 5943 | 14,640 | 5622–6264 | 12,114 | 11,314–12,914 | < 0.001 | 67.1 |
Year +3 | 925 | 46.5 | 17,995 | 21,716 | 17,040–18,950 | 1509 | 18.9 | 6542 | 15,382 | 6205–6880 | 11,453 | 10,626–12,280 | < 0.001 | 63.6 |
Year +4 | 941 | 47.3 | 18,819 | 22,296 | 17,839–19,800 | 1579 | 19.8 | 7043 | 16,094 | 6690–7396 | 11,776 | 10,916–12,637 | < 0.001 | 62.6 |
Sickness absence costsc | ||||||||||||||
Year −4 | 273 | 13.7 | 4372 | 12,232 | 3834–4911 | 911 | 11.4 | 3228 | 10,510 | 2997–3458 | 1145 | 610–1679 | < 0.001 | 26.2 |
Year −3 | 259 | 13.0 | 4214 | 12,234 | 3676–4752 | 840 | 10.5 | 3053 | 10,438 | 2823–3282 | 1162 | 630–1693 | < 0.001 | 27.6 |
Year −2 | 270 | 13.6 | 4330 | 12,541 | 3778–4881 | 755 | 9.5 | 2641 | 9740 | 2428–2855 | 1688 | 1179–2197 | < 0.001 | 39.0 |
Year −1 | 383 | 19.3 | 5966 | 14,289 | 5338–6595 | 748 | 9.4 | 2686 | 9873 | 2469–2902 | 3281 | 2746–3816 | < 0.001 | 55.0 |
Year 0 | 838 | 42.2 | 14,164 | 19,684 | 13,299–15,030 | 798 | 10.0 | 2914 | 10,302 | 2688–3140 | 11,251 | 10,625–11,877 | < 0.001 | 79.4 |
Year +1 | 740 | 37.2 | 13,766 | 20,118 | 12,881–14,651 | 844 | 10.6 | 3087 | 10,579 | 2855–3319 | 10,679 | 10,038–11,320 | < 0.001 | 77.6 |
Year +2 | 708 | 35.6 | 13,197 | 19,961 | 12,319–14,075 | 931 | 11.7 | 3441 | 11,177 | 3196–3686 | 9756 | 9098–10,414 | < 0.001 | 73.9 |
Year +3 | 621 | 31.2 | 11,366 | 19,123 | 10,525–12,207 | 1015 | 12.7 | 3885 | 11,959 | 3623–4147 | 7481 | 6808–8154 | < 0.001 | 65.8 |
Year +4 | 553 | 27.8 | 10,407 | 18,904 | 9576–11,239 | 1069 | 13.4 | 4218 | 12,601 | 3942–4495 | 6189 | 5497–6881 | < 0.001 | 59.5 |
Disability pension costs | ||||||||||||||
Year −4 | 156 | 7.9 | 2915 | 10,538 | 2452–3379 | 536 | 6.7 | 2450 | 9709 | 2237–2663 | 465 | −21 to 950 | 0.061 | 16.0 |
Year −3 | 176 | 8.9 | 3282 | 11,233 | 2788–3776 | 557 | 7.0 | 2616 | 10,147 | 2394–2839 | 666 | 156–1176 | 0.011 | 20.3 |
Year −2 | 184 | 9.3 | 3423 | 11,450 | 2919–3927 | 557 | 7.0 | 2713 | 10,440 | 2484–2942 | 710 | 186–1233 | 0.008 | 20.7 |
Year −1 | 178 | 9.0 | 3335 | 11,364 | 2836–3835 | 543 | 6.8 | 2629 | 10,299 | 2403–2855 | 706 | 189–1223 | 0.007 | 21.2 |
Year 0 | 192 | 9.7 | 3474 | 11,456 | 2970–3978 | 526 | 6.6 | 2508 | 10,036 | 2288–2729 | 966 | 458–1474 | < 0.001 | 27.8 |
Year +1 | 245 | 12.3 | 4251 | 12,551 | 3699–4803 | 507 | 6.4 | 2524 | 10,180 | 2301–2748 | 1727 | 1202–2253 | < 0.001 | 40.6 |
Year +2 | 347 | 17.5 | 5680 | 14,158 | 5057–6303 | 524 | 6.6 | 2593 | 10,334 | 2366–2820 | 3087 | 2537–3638 | < 0.001 | 54.3 |
Year +3 | 462 | 23.2 | 7671 | 15,896 | 6972–8370 | 551 | 6.9 | 2770 | 10,739 | 2534–3005 | 4901 | 4314–5488 | < 0.001 | 63.9 |
Year +4 | 543 | 27.3 | 9553 | 17,590 | 8780–10,327 | 566 | 7.1 | 2932 | 11,181 | 2687–3177 | 6622 | 5997–7246 | < 0.001 | 69.3 |
EUR Euros, MS multiple sclerosis, SEK Swedish krona
aMean costs were calculated for all 1988 PwMS and the 7981 population-based matched references without MS, respectively in the study population, irrespective of resource use. All costs are presented in Euros in 2019 values. The annual exchange rate for 2019 from SEK to EUR that was used was 10.5891 [38]
bThe percentage excess refers to the mean difference between PwMS and references as a proportion of the mean of that cost component for PwMS
cIn order not to introduce bias in relation to employment status, only sickness absence periods >14 days were included. There is a slight overestimation of the sickness absence-related productivity losses in the disaggregated costs (range: 0.3–1.2% of the cohort per year) due to capping of the net days of sickness absence and disability pension combined at the number of possible days in the year in calculating total productivity losses in cases where the number of net days combined exceeded the possible days in the year