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Modelling the impact of multiple sclerosis on life expectancy, quality-adjusted life years and total lifetime costs: evidence from Australia


Palmer, AJ and van der Mei, I and Taylor, BV and Clarke, PM and Simpson Jr, S and Ahmad, H, Modelling the impact of multiple sclerosis on life expectancy, quality-adjusted life years and total lifetime costs: evidence from Australia, Multiple Sclerosis Journal pp. 1-10. ISSN 1352-4585 (2019) [Refereed Article]

Copyright Statement

Copyright 2019 The Authors

DOI: doi:10.1177/1352458519831213


Objectives: To quantify life expectancy (LE), quality-adjusted life years (QALYs) and total lifetime societal costs for a hypothetical cohort of Australians with multiple sclerosis (MS).

Methods: A 4-state Markov model simulated progression from no/mild to moderate and severe disability and death for a cohort of 35-year-old women over a lifetime horizon. Death risks were calculated from Australian life tables, adjusted by disability severity. State-dependent relapse probabilities and associated disutilities were considered. Probabilities of MS progression and relapse were estimated from AusLong and TasMSL MS epidemiological databases. Annual societal (direct and indirect) costs (2017 Australian dollars) and health-state utilities for each state were derived from the Australian MS Longitudinal Study. Costs were discounted at 5% annually.

Results: Mean (95% confidence interval (CI)) LE from age 35 years was 42.7 (41.6-43.8) years. This was 7.5 years less than the general Australian population. Undiscounted QALYs were 28.2 (26.3-30.0), a loss of 13.1 QALYs versus the Australian population. Discounted lifetime costs were $942,754 ($347,856-$2,820,219).

Conclusion: We have developed a health economics model of the progression of MS, calculating the impact of MS on LE, QALYs and lifetime costs in Australia. It will form the basis for future cost-effectiveness analyses of interventions for MS.

Item Details

Item Type:Refereed Article
Keywords:Australia, Markov model, multiple sclerosis, QALYs, life expectancy, lifetime costs
Research Division:Biomedical and Clinical Sciences
Research Group:Neurosciences
Research Field:Central nervous system
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Palmer, AJ (Professor Andrew Palmer)
UTAS Author:van der Mei, I (Professor Ingrid van der Mei)
UTAS Author:Taylor, BV (Professor Bruce Taylor)
UTAS Author:Simpson Jr, S (Dr Steve Simpson JR)
UTAS Author:Ahmad, H (Mr Hasnat Ahmad)
ID Code:131139
Year Published:2019
Web of Science® Times Cited:1
Deposited By:Menzies Institute for Medical Research
Deposited On:2019-03-05
Last Modified:2020-03-04

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