Background:
Canada has the highest prevalence of multiple sclerosis (MS) worldwide. Since the onset of MS typically happens between the ages of 20 and 40 years, the most productive years of life may be affected with challenges such as unemployment and disability. The MS Society of Canada’s Action on MS report emphasizes that nearly 80 percent of people affected by MS may find themselves unemployed. For neurological diseases like MS, the Government of Canada initiated the National Population Health Study of Neurological Conditions (NPHSNC) to better understand these diseases with the hope of reducing their burden on quality of life. To further understand the future landscape of MS in Canada, Nana Amankwah and colleagues including MS Society-funded researcher Dr. Ruth Ann Marrie used a modelling system to project the long-term health and economic impacts of MS across the country using information from NPHSNC. Their research was recently published in Health Promotion and Chronic Disease Prevention in Canada journal.
The Study:
The researchers used results from the NPHSNC (consisting of data compiled from 13 research projects and 3 national surveys) and modelling software from Statistics Canada (Population Health Microsimulation Model (POHEM)) to project the effects of MS over a 20-year horizon within Canada. Factors such as migration, birth and death rates from 1872 to early 2000s were taken into consideration. Specific characteristics of individuals with MS were collected, such as age and province of residence, MS status, health status, caregiver support status, healthcare costs, and date of death. The researchers used information from NPHSNC and applied it to POHEM to examine the prevalence, heath and economical burden of MS in Canada in 2031.
Results:
The researchers reported that the incidence of MS in Canada is expected to increase from 4051 to 4794 cases in 100,000 people between 2011-2031. This roughly translates into an estimated 98,000 people living with the disabling effects of MS in 2011 to a projected increase to 133,000 people in 2031.The study also noted that, in 2011, an individual with MS spent approximately $17,000 for health care costs over the year compared to approximately $2,500 spent by people without MS. Based on this information, the projected cost to the health care sector from MS is expected to be $2 billion by 2031. Additionally, total out-of-pocket costs for people living with MS in Canada in 2011 was $125 million, a number that is expected to increase to $170 million by 2031.
Comment:
Findings from this study are key to demonstrating the economic impact of MS on the Canadian population, and to use the data to predict future trends. What is clear from these results is that there will be an increase in economic burden of MS, which highlights the need to understand and more effectively manage costs associated with the disease.
The study has reported a number of important limitations. Firstly, the model does not account for risk factors that may contribute to MS as it remains unclear which risk factor is the most prominent in the development of MS. Second, it does not account for individuals with the onset of MS younger than 20 years old. This excludes nearly 5% of individuals which have MS-like symptoms under the age of 20 years old. Finally, these findings do not account for the development of future treatments that may stop, delay or reverse progression of MS. The MS Society of Canada continues to fund high impact research in the hopes that game-changing treatments that reduce progression, begin treatment earlier and potentially prevent the disease are available for individuals with MS. In addition to research, the MS Society priorities also include advocacy efforts with the government to provide access to adequate services and treatments that will improve quality of life for people with MS and ultimately reduce the cost to both the person and health care system.
Source:
Amankwah N. et al. (2017) Multiple sclerosis in Canada 2011 to 2031: results of a microsimulaiton modelling study of epidemiological and economic impacts. Health Promot Chronic Dis Prev Can: 37(2), 37-48.