Multiple sclerosis (MS) is associated with a significant economic burden, not only in terms of direct costs (drugs, hospital admissions, healthcare aids), but also indirect costs including loss of income, reduction of productivity, burden on caregivers and family members, and a reduction in patient quality of life (QoL). The disease has a marked effect on employment, with less than 20 % of patientsof working age in employment at higher disability levels (Expanded Disability Status Scale [EDSS] 6.0–8.0). Disabilities, fatigue, cognitive impairments, transportation difficulties, speech impairments and bladder and bowel problems all impact on the patient’s ability to work and their QoL. The economic costs of MS do not just impact the patient. The stress and physical burden of caring for a friend or relative withMS may also impact on the finances and health of caregivers and increase their own requirement for healthcare resources. The increasing availability of disease-modifying drugs (DMDs) and earlier diagnosis of the condition has resulted in an increase in the directcosts of MS related to expenditure on DMDs. However, due to the significant increase in costs that are associated with increasing disease severity, interventions aimed at delaying disease progression may help to reduce the economic burden of MS. This article will review the direct, indirect and intangible costs of MS and discuss the economic impact of drug development on these costs.
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