Gender Disparities in Costs for Patients with MS

Gender differences in terms of costs for patients with multiple sclerosis (MS) are not fully understood but are worth investigating further to garner a full understanding of the cost of the disease, how this differs among patients, and how to allocate resources appropriately. A study explored healthcare resource utilization and related societal costs between men and women with MS. Although the overall economic burden was not significantly different between male and female patients, for certain items, sex-based differences were observed.

Data were collected from two Germany-based prospective, multicenter, non-interventional, observational studies. A validated quarterly questionnaire was distributed to patients to glean health resource utilization information. Cost analyses, including direct (healthcare-related) and indirect (work-related) costs, were performed from the societal perspective. A multivariable generalized linear model with a negative binomial distribution and log link function due to the right-skewed distribution pattern of cost data was implemented to examine gender-related disparities. Costs were further examined within subgroups of two-year disease activity for both sexes.

Final analysis included 2,095 patients with a mean age of 41.85 years. The median Expanded Disability Status Scale was 2 (range, 1.0-3.5; P<0.30 for gender-related differences).

Total quarterly costs were similar between women (€2,329 ± €2,570) and men (€2,361 ± €2,612). Advancing disease severity was associated with increased costs for both groups, and indirect costs were the primary factor in societal costs. Women, compared with men, had higher costs for ambulant consultations (incidence rate ratio [IRR], 1.16; confidence interval [CI], 1.04-1.31], complementary medicine (IRR, 2.41; CI, 1.14-5.06), medical consumables (IRR, 2.53; CI, 1.69-3.79), and informal care (IRR, 2.79; CI, 1.56-5.01). Regarding indirect costs, men had higher costs for presenteeism (IRR, 0.62; CI, 0.53-0.72), while women had higher costs for disability pension (IRR, 1.62; CI, 1.23-2.13).

“Future analyses might focus on the quantification of additional areas of unpaid work, gender differences in costs in more severely affected [patients with relapse-remitting] MS, as well as patients with primary or secondary progressive MS phenotypes,” the study authors concluded.