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Health-related outcomes, health care resource utilization, and costs of multiple sclerosis in Japan compared with US and five EU countries

Authors Yamabe K, DiBonaventura MD, Pashos CL

Received 11 July 2018

Accepted for publication 23 October 2018

Published 7 January 2019 Volume 2019:11 Pages 61—71

DOI https://doi.org/10.2147/CEOR.S179903

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Giorgio Colombo


Kaoru Yamabe,1 Marco D DiBonaventura,2 Chris L Pashos3

1Healthcare Policy and Access, Takeda Pharmaceutical Company Limited, Chuouku, Tokyo 103-8668, Japan; 2Health Outcomes, Kantar Health, New York, NY 10010, USA; 3Global Outcomes and Epidemiology Research. Data Sciences Institute, Takeda Pharmaceutical International, Cambridge, MA 02139, USA

Purpose: Multiple sclerosis (MS) imposes a huge burden on patients. This study examined the relationship between MS and health-related and economic burden in Japan; secondarily, health status was compared across patients with MS in Japan, US, and five European Union (5EU) countries (France, Germany, Italy, Spain, and UK).
Methods: A retrospective cross-sectional study was conducted using self-reported data from 2009 to 2014 Japan National Health and Wellness Survey (n=145,759). Health status, work productivity loss, activity impairment, health care resource utilization, and annual costs associated with MS (n=85) were compared with controls without MS (n=145,674). Propensity score matching and multivariable linear regressions determined the effect of MS after controlling for confounders. Health status in Japan was also compared with that of 5EU (n=62) and US (n=67) patients with MS.
Results: Patients with MS in Japan reported significantly worse health status via mental component summary score (MCS; 40.1 vs 45.8) and physical component summary score (PCS; 41.4 vs 51.2) and health state utility scores (0.63 vs 0.74; all P<0.001). They also reported more absenteeism (12.0% vs 3.7%), presenteeism (33.8% vs 19.8%), overall work impairment (40.9% vs 21.6%), and activity impairment (43.6% vs 24.0%), with higher indirect costs (¥2,040,672/US $20,102 vs ¥1,076,306/US$10,603) than controls (all P<0.001). Patients with MS reported higher resource use, including provider visits (8.0 vs 4.7), emergency room visits (0.03 vs 0.1), and hospitalizations (2.7 vs 0.69) in the past 6 months, with higher direct costs (¥3,670,906/US$36,162 vs ¥986,099/US$9,714) than controls (all P<0.001). Finally, Japanese patients with MS reported lower MCSs and higher PCSs than their US and 5EU counterparts.
Conclusion: MS in Japan is associated with poor health status and high work productivity loss, resource use, and costs, underscoring the need for improved treatment, especially vis-à-vis mental health, when comparing Japanese patients with their 5EU and US counterparts.

Keywords: activity impairment, direct costs, health care resource utilization, health status, indirect costs, work productivity impairment

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