Costos de la esclerosis múltiple en Colombia

OBJECTIVE: To estimate, according to the states of disease (remission or relapse) and her level of progression (EDSS), the cost of treatment of Multiple Sclerosis (MS) in Colombia.

METHODS: From the perspective of the third payer, a cost study of MS was performed using two-way estimation techniques: a) "Top down" to estimate the costs during relapses from clinical registers of 304 patients; b) "bottom-up" to estimate the cost in remission from a questionnaire (Kobelt 2006) applied to 137 patients, located in different regions of Colombia.

RESULTS: The mean of patient's age was 43,7 years and 73% of those were women. The mean annual cost per patient varied according to the disease phase, finding the highest value in Phase II (EDSS 3 - 5,5) with $ 50.581.216 COP (US$ 25.713) and the lowest one in Phase IV (EDSS 8 - 9,5) with $20.738.845 COP (US$ 10.543). The cost of Disease Modifier Drugs (DMD) represented 91.5% from the medial total annual cost of 1,2 and 3 phases. The participation of DMD was 58%.in the 4 phase. Indirect costs are minimal participation in all phases, except for 4 where increases at the expense of reduced consumption of DMD. Costs associated with the period of relapses of MS are low against the total cost, with an average cost of $ 2,433,182 COP ($ 1.237 USD).

DISCUSSION: MS in Colombia is a disease with a behavioral pathology "high cost " to the social security system (SGSSS), generated mainly at the expense of their direct costs, which, even without including relapses, an aggregate amount of more than 75 times the annual premium cost of health insurance for Colombia ($ 430,488 COP) in the year under review (2008).