Epidemiology and costs of multiple sclerosis in Switzerland: an analysis of health-care claims data, 2011–2015
Received 3 June 2017
Accepted for publication 1 September 2017
Published 1 November 2017 Volume 2017:13 Pages 2737—2745
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Roger Pinder
Eva Blozik,1–3 Roland Rapold,1 Klaus Eichler,4 Oliver Reich1
1Department of Health Sciences, Helsana Group, Zürich, Switzerland; 2Institute of General Practice, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 3Division of General Practice, University Medical Center Freiburg, Freiburg, Germany; 4Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland
Background: Medical therapy for multiple sclerosis (MS) is expensive. Quantifying the burden of MS is fundamental for health-care planning and the allocation of resources for the management of MS. This study provides current national estimates of prevalence, incidence, mortality, and costs of MS in Switzerland using claims data between 2011 and 2015.
Methods: We analyzed health insurance claims of adult persons enrolled with a large health insurance group covering about 13% of the Swiss population between 2011 and 2015. The identification of patients with MS was based on prescription data of MS-specific medication using the Anatomical Therapeutic Chemical Classification system as proxy for clinical diagnosis. We estimated prevalence, mortality, and costs of basic health insurance between 2011 and 2015. Furthermore, incidence of MS was calculated for 2015. All results were weighted with census data to achieve an extrapolation to the Swiss general population level. Cost of illness was estimated as direct medical cost from the perspective of a Swiss health insurance using multivariate linear regression analysis.
Results: Of the 943,639 subjects in the year 2015, 1,606 were identified as MS patients resulting in a prevalence of 190 per 100,000 (95% CI: 180-190 per 100,000). Incidence was 16 per 100,000 (95% CI: 13-19 per 100,000). According to regression analysis, the total cost of illness for basic mandatory health insurance was 26,710 Swiss Francs (CHF) (95% CI: 26,100–27,300) per person per year with the cost of medication being almost identical 26,960 CHF (95% CI: 26,170–27,800).
Conclusions: MS affects 10,000–15,000 persons in Switzerland, and the prevalence has increased over the last 22 years. These persons have high need and demand for health care. High costs are primarily due to expenses for medication. Given the imbalance of MS medication therapy from the perspective of basic health insurance on the disposable resources, it is crucial to increase transparency related to the volume, type, and allocation of expenses.
Keywords: health insurance, Switzerland, medication, prescription, management, resources
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