Cost of Illness of Multiple Sclerosis in Isfahan, Iran, From a Social Perspective: A Comparison of the Human-Capital and Friction-Cost Methods

Abstract

Objectives: Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system that is characterized by demyelination and neurodegenerative changes and associated with high levels of disability. This study aimed to investigate direct and indirect costs of illness of patients with MS in Isfahan using and comparing human-capital and friction-cost methods from a societal perspective. Methods: A total of 300 patients with MS of 2 main centers of the disease in Isfahan, the MS center of Ayatollah Kashani hospital and Isfahan MS center, were included. Patient's demographic characteristics, disease information, and annual social costs (2018-2019) were collected using data collection form. Both the human-capital and friction-cost methods were applied and compared with value indirect costs because of loss of productivity. Results: From the social perspective, the average annual total cost of MS disease was estimated to be 1 441163 710 rials (34 313 US dollar USD) per patient using the human-capital approach and 1 434 832 004 rials (34162 USD) with the use of friction-cost method, from which 1 428 668 396 rials (34016 USD) was related to direct costs. The main direct costs were related to disease-modifying therapies and referring to other physicians and hospitals. The cost of loss of production was greater with human-capital approach in comparison with friction-cost method. Conclusions: The most prominent cost in MS disease is related to drug costs. The indirect costs were sensitive to the methods, applied in the study.