Socioeconomic burden of multiple sclerosis: Insights from a cohort in Coimbra, Portugal

INTRODUCTION: Multiple Sclerosis (MS) is the leading cause of non-traumatic disability in young adults, burdening patients, caregivers, and healthcare systems. In Portugal, annual direct healthcare costs for MS are estimated between €12,303 and €16,451, with total costs reaching €34,400 per patient. This study aims to characterize MS patients in Coimbra, focusing on demographic, clinical, and economic aspects to assess the disease's socioeconomic impact. METHODS: A cost-of-illness study with cross-sectional and retrospective components was conducted between 2021 and 2022 at the single referral center for MS in Coimbra. Patients completed a survey assessing sociodemographic, clinical, and economic data. Descriptive and comparative non-parametric analyses stratified by MS severity (mild EDSS 0-3.5, moderate 4-6.5, severe above 6.5) were performed. RESULTS: Among 163 patients (69.9 % female, mean age 48), 87.1 % had relapsing-remitting MS. Higher education was common (69.3 %), 45.4 % were married. Employment declined with disease severity; 9.4 % of mild EDSS patients were unemployed, while severe EDSS patients were retired. Average annual direct healthcare costs were €12,406, increasing with severity (€12,267 in mild MS to €16,020 in severe MS). Disease-modifying therapies accounted for most direct costs, although these declined in advanced stages, with hospitalization costs rising. Total costs per patient were €14,954 (mild MS), €28,289 (moderate MS), and €35,557 (severe MS), with relapses adding €3277 annually. CONCLUSION: This study underscores the substantial economic burden of MS, particularly as disease severity progresses. Rising hospitalization and relapse costs highlight the need for cost-effective strategies and policies reducing MS-related socioeconomic impacts. Effective management could help mitigate these costs while improving outcomes.