The Clinical and Economic Burden of Primary Progressive Multiple Sclerosis
A retrospective matched-cohort study investigated the real-world clinical and economic burden of primary progressive multiple sclerosis (PPMS) in the US. Using administrative claims data from 2018 to 2023, researchers analyzed 3587 individuals with PPMS and an equal number of matched controls without multiple sclerosis (MS). The study found that people with PPMS had significantly more comorbidities, including infections (81.8% vs 49.3%), leukopenia (2.6% vs 0.7%), and elevated liver transaminase levels (1.1% vs 0.5%) compared to controls. MS-related symptoms were also far more prevalent among those with PPMS compared to the controls, with abnormal gait occurring at 66.7% vs 3.4%, fatigue in 56.9% vs 15.7%, depression in 36.5% vs 11.3%, muscle weakness in 34.4% vs 2.8%, and urinary incontinence in 30.1% vs 3.0%, respectively.
Health care resource utilization was considerably greater among patients with PPMS, with more requiring ambulatory devices (74.3% vs 9.8%) as well as physical (67.5% vs 16.1%), occupational (75.4% vs 19.4%), and speech therapy (3.2% vs 0.2%). Hospitalization and physician visits were also notably higher, with the PPMS group experiencing more frequent hospitalizations (33.3% vs 11.0%), emergency department visits (45.4% vs 18.3%), and physician visits (40.0 vs 13.4 per patient on average). The study further revealed a significant financial burden, as the total health care costs for patients with PPMS were substantially higher than those of the control group, amounting to $147 443 compared to $21 842. This difference was primarily driven by medical claims ($105 917 vs $16 213) and nonemergency outpatient services ($82 360 vs $9458).
Overall, the study underscores the severe clinical and economic burden faced by individuals with PPMS. With limited approved treatment options available, these findings highlight the urgent need for better therapeutic strategies and health care interventions to support this underserved population.
Reference
Greene N, Das A, Hemim I, Chang E, Tarbox M. Understanding the burden of illness in people with primary progressive multiple sclerosis in the United States: a matched-cohort study. Presented at: 2025 ACTRIMS Forum; February 27-March 1; West Palm, Beach, FL; Abstract P411.
