Number of multiple sclerosis (MS) patients in Montenegro amounts to 650, with 61% of them receiving disease modifying therapy (DMT). Since 2017 number of treated patients has been increased from 16% to 61% due to improved access to DMTs. When patients diagnosed with secondary progressive form of MS, for which there is no approved therapy in Montenegro, and patients with a primary progressive form of MS who are already in an advanced stage of the disease (EDSS >7) are excluded from the total number, so all MS patients in Montenegro who need DMT have access to it.
Since the access to adequate treatment is not questionable in Montenegro, the objective of the study was to identify the importance of early access to DMT.
The analysis was based on data collected from questionnaires filled by 138 patients who started the treatment after less than two years upon the diagnosis of MS and 81 patients who started the treatment after more than two years, or who do not receive therapy, as well as on data collected during two focus groups with the patients. We have used three indicators that measure work ability and productivity: two monetized – Productivity and Disease Questionnaire (PRODISQ) and Work Productivity and Activity Impairment Questionnaire: Multiple Sclerosis V2.1 (WPAI:MS), and one non-monetized – The Health and Work Performance Questionnaire (HPQ).
The results of PRODISQ suggest that the average annual loss caused by decreased productivity per MS patient in Montenegro is 35% higher in situation when patients received their treatment after more than two years after the diagnosis. Total cost of decreased productivity of MS patients in Montenegro is approximately 1 million EUR per annum, equivalent to 27,160 working days per annum. WPAI:MS suggests that the average annual cost of absenteeism per patient who received the therapy later is 2.3 times higher than it is for a patient recieved earlier. Total cost of absenteeism of MS patients in Montenegro is approximately 190 thousand EUR per annum. HPQ analysis suggests that the patients with earlier access to therapy are on average three times less absent from work. It also shows that, by the subjective feelings of patients, productivity is similar, or even higher than the average productivity of other employees with similar job, if the patient had earlier access to therapy, and lower than the average, it he/she didn’t.
Earlier access to MS therapy provided to greater number of patients would result in significant reduction of lost productivity costs in Montenegro. The results were further reinforced by the findings from the focus groups, where the respondents emphasized that timely access to adequate therapy enabled them to preserve their working productivity. This was the first of a kind research in Montenegro and these national data will be strong recommendation towards promoting economic benefits of early MS treatment for the patients and for the Healthcare system as well.