The Epidemiology, Treatment Patterns and Economic Burden of Different Phenotypes of Multiple Sclerosis in Italy: Relapsing-Remitting Multiple Sclerosis and Secondary Progressive Multiple Sclerosis

Purpose: A retrospective analysis of real-world data was performed to assess the epidemiology and economic burden of multiple sclerosis (MS), relapsing-remitting MS (RRMS), and secondary-progressive MS (SPMS) in Italy.Patients and Methods: An observational study on administrative databases from a sample of Italian entities was carried-out. Between 01/2010-12/2017, patients with 21 MS diagnosis code (ICD-9-CM:340 and/or exemption code:046) and/or 21 disease -modifying therapies (DMTs) prescription, were included. Among MS-cohort, SPMS patients were identified by 22 hospitalizations or by 22 drug prescriptions related to MS progression. MS patients not fulfilling SPMS criteria were included as RRMS. Mean annual healthcare costs were reported during follow-up and stratified by DMT treatment/untreatment.Results: Overall, 9543 MS patients were included; 8397 with RRMS and 1146 with SPMS. Estimated prevalence of MS was 141.6/ 100,000 inhabitants (RRMS 124.4/100,000 and SPMS 17.2/100,000). Mean annual cost for untreated and treated patient was respectively: euro 3638 and euro 11796 (MS-cohort), euro 3183 and euro 11486 (RRMS-cohort), euro 6317 and euro 15511 (SPMS-cohort). The first-line DMT treatment duration averaged 27.4 +/- 22.8 months; the mean cost was 19004 euro for the whole period. The second-line DMT treatment lasted on average 31.1 +/- 24.5 months; the mean cost was 47293 euro for the whole period.Conclusion: This study provided insights into the MS epidemiology in Italy and its economic burden. Healthcare costs associated with MS management were mainly driven by DMTs expenditure. A trend of higher healthcare-resource consumption was observed among SPMS-cohort.