# An updated review of the economic burden of multiple sclerosis: direct and indirect costs

## TL;DR

This paper reviews the economic costs of multiple sclerosis, highlighting high direct and indirect expenses like drug costs and productivity losses.

## Contribution

The study provides updated estimations of MS economic burden using recent literature and highlights underestimation issues.

## Key findings

- Living with MS involves significant direct and indirect costs.
- Drug costs and productivity losses are major cost determinants.
- Current estimates may underestimate the true economic burden of MS.

## Abstract

Multiple sclerosis (MS) is a chronic, inflammatory, autoimmune disease of the central nervous system and represents one of the most common causes of accumulated disability in young adults. Although, currently in the vast majority of cases MS is not a determinant of death, its effects on patients can result in considerable health problems. This research provides new estimations of the total economic burden (direct -based on the difference in the total average annual amount vs matched controls without MS - and indirect costs- e.g., labor market productivity losses (premature death, presenteeism, and absenteeism losses, costs of paid and unpaid caregivers, home changes-). A literature review of English language studies published in the last 6 years is conducted to analyze the costs of MS. We search PubMed, Web of Science and Scopus as databases. The search identified 131 unique records, 31 of which met the inclusion criteria. Living with MS is expensive as a significant chronic disease. The important cost determinants are the direct costs of drugs and indirect productivity loss. Our findings show that the burden of MS needs to overcome the underestimation problems.