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dc.titleCost Analysis Of Multiple Sclerosis In Brazil: A Cross-sectional Multicenter Studyen
dc.contributor.authorda Silvapt_BR
dc.contributor.authorNilceia Lopes; Takemotopt_BR
dc.contributor.authorMaira L. S.; Damascenopt_BR
dc.contributor.authorAlfredo; Fragosopt_BR
dc.contributor.authorYara D.; Finkelsztejnpt_BR
dc.contributor.authorAlessandro; Beckerpt_BR
dc.contributor.authorJefferson; Goncalvespt_BR
dc.contributor.authorMarcus V. M.; Tilberypt_BR
dc.contributor.authorCharles; de Oliveirapt_BR
dc.contributor.authorEnedina M. L.; Callegaropt_BR
dc.contributor.authorDagoberto; Boulospt_BR
dc.contributor.authorFernanda C.pt_BR[Damasceno, Alfredo] Univ Estadual Campinas, Sch Med, Campinas, SP, Brazilpt_BR[da Silva, Nilceia Lopespt_BR, Fernanda C.] Novartis Biociencias SA, Av Prof Vicente Rao 90, BR-04636000 Sao Paulo, SP, Brazilpt_BR[Takemoto, Maira L. S.] ANOVA Traducao Conhecimento Saude, Rio De Janeiro, RJ, Brazilpt_BR[Fragoso, Yara D.] Univ Metropolitana Santos, Sch Med, Santos, SP, Brazilpt_BR[Finkelsztejn, Alessandro] HC Porto Alegre, Dept Neurol, Porto Alegre, RS, Brazilpt_BR[Becker, Jefferson] Pontificia Univ Catolica Rio Grande do Sul, Hosp Sao Lucas, Porto Alegre, RS, Brazilpt_BR[Goncalves, Marcus V. M.] Hosp Reg Hans Dieter Schimidt, Joinville, SC, Brazilpt_BR[Tilbery, Charles] Santa Casa Misericordia Sao Paulo, Div Neurol, Sao Paulo, SP, Brazilpt_BR[de Oliveira, Enedina M. L.] Univ Fed Sao Paulo, Sao Paulo, Brazilpt_BR[Callegaro, Dagoberto] Univ Sao Paulo, Hosp Clin, Sao Paulo, SP, Brazilpt_BR
dc.subjectMultiple Sclerosisen
dc.subjectCost Analysisen
dc.subjectCost Of Illnessen
dc.subjectQuality Of Lifeen
dc.description.abstractMultiple sclerosis (MS) is a central nervous system disease associated with irreversible progression of disability, which imposes a substantial socioeconomic onus. The objective of this study was to determine the economic impact of multiple sclerosis from the Brazilian household and healthcare system perspectives. Secondary objectives were to assess the impact of fatigue on daily living and health-related quality of life (HRQL) of MS patients. Methods: This is a cross-sectional study in which Brazilian eligible patients attending eight major MS specialized sites answered an interview capturing data on demographics, disease characteristics and severity, comorbidities, resource utilization, fatigue, utilities and health-related quality of life from November/2011 to May/2012. Costs were assessed considering a prevalence-based approach within 1 year of resource consumption and were estimated by multiplying the amount used by the corresponding unit cost. Patients were classified as having mild, moderate or severe disability according to the Expanded Disability Status Scale (EDSS). Results: In total, 210 patients who met eligibility criteria were included, 40 % had mild, 43 % moderate and 16 % severe disability; disability level was missing for 1 %. The average total direct cost per year was USD 19,012.32 (SD = 10,465.96), and no statistically significant differences were not observed according to MS disability level (p = 0.398). The use of disease modifying therapies (DMTs) corresponded to the majority of direct expenditures, especially among those patients with lower levels of disability, representing around 90 % of total costs for mild and moderate MS patients. It was also observed that expenses with medical (except DMTs) and non-medical resources are higher among patients with more severe disease. Worsening disability also had an important influence on health-related quality of life and self-perceived impact of fatigue on daily living. Conclusion: Our data demonstrates the significant economic impact of MS on both Brazilian household and health system, in terms of DMTs and other disease management costs. When patients move upwards on the disease severity scale, costs with health resources other than drugs are significantly increased.en
dc.relation.ispartofBMC Health Services Researchpt_BR
dc.publisherBiomed Central Ltdpt_BR
dc.identifier.citationBmc Health Services Research. Biomed Central Ltd, v. 16, p. , 2016.pt_BR
dc.description.sponsorshipNovartis Biociencias S.A.pt_BR
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