Fiche publication
Date publication
juin 2014
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BINQUET Christine
Tous les auteurs :
Fromont A, Lehanneur MN, Rollot F, Weill A, Clerc L, Bonithon Kopp C, Binquet C, Moreau T
Lien Pubmed
Résumé
Multiple sclerosis (MS) is one of the 30 chronic conditions specifically listed by the French healthcare system as a long-term disease (affections de longue duree [ALD]) for which the main health insurance fund (Caisse nationale d'assurance maladie des travailleurs salaries [CNAMTS]) provides full (100%) coverage of healthcare costs. The CNAMTS insures 87% of the French population (52,359,912 of the 60,028,292 inhabitants). The objectives of this study were to evaluate the direct and indirect medical costs of MS among the entire population insured by the CNAMTS in France in 2004. The CNAMTS provided us with access to the ALD database of patients with MS that contains different MS-related expenditures made in 2004. We calculated the overall direct and indirect cost of MS and the cost per patient and per item of expenditure. In 2004, 49,413 patients were registered on the ALD list for MS. Direct cost for MS patients was 469,719,967 euro. The direct cost per patient and per year was 9,506 euro with variations between regions (French administrative divisions) ranging from 10,800 euro in northeastern France (Champagne-Ardenne) to 8,217 euro in western France (Pays de la Loire). The different items of expenditure were treatments (44.5%), hospitalization (27.9%), nursing care (5.8%), physiotherapy (5.7%), transport (4%), biology (1.1%), and other (1.5%). During the course of the disease, the overall cost of MS increased slowly during the first 15 years (from 8,000 to 11,000 euro), but dramatically the last year of life (23,410 euro). The costs of immunomodulator treatments were higher during the first six years after registration on the ALD list. Conversely, physiotherapy costs increased linearly with time during the course of MS. Indirect costs were an estimated 116 million euros in 2004. A disability pension (8,918 euro per patient) was perceived by 9,430 patients (19.1%) and a daily allowance (3,317 euro per patient) by 9,894 patients (20%). In France, MS has an important economic impact, comparable to human immunodeficiency virus infection.
Référence
Rev Neurol (Paris). 2014 Jun-Jul;170(6-7):432-9
