Complex Societal and Economic Impact of Sclerosis Multiplex in Slovakia: Decade-long Burden of Disease Moving Beyond Healthcare

Abstract Introduction Multiple sclerosis (MS) is a chronic inflammatory and demyelinating disease of the central nervous system predominantly affecting young adults of working age, with significant implications for patients, healthcare systems, and society. Globally, MS prevalence reached 2.8 million in 2020, a 32% increase since 2013, with Europe showing the highest incidence. The economic burden extends beyond direct healthcare costs to include substantial indirect costs such as productivity losses and informal care. In Slovakia, prior studies focused mainly on direct costs, but evolving treatment options and healthcare delivery necessitate a comprehensive assessment of both direct and indirect costs over the last decade. Methods This study conducted a retrospective, prevalence-based analysis of the economic burden of MS in Slovakia from 2013 to 2022, adopting a societal perspective. Data were obtained from national health insurance companies for direct healthcare costs and the Social Insurance Agency for indirect costs related to productivity losses. The human capital approach was used to estimate productivity loss costs. The methodology aligns with European cost-of-illness frameworks, distinguishing direct costs (drugs, therapies, hospitalizations) from indirect costs (work disability, absenteeism, informal care). Results MS prevalence in Slovakia increased by 43.3% between 2013 and 2022. Direct healthcare costs rose by 62.4%, driven primarily by pharmacotherapy and medical services. Indirect costs, especially those related to work disability, increased substantially, with per-patient indirect costs rising by 51%. The total economic burden reflects a significant and growing impact on both healthcare resources and societal productivity, underscoring the need for effective resource allocation. Conclusions The study highlights the substantial and increasing economic burden of MS in Slovakia, emphasizing the importance of incorporating both direct and indirect costs in healthcare planning. Findings support the need for updated resource allocation strategies and targeted interventions to address productivity loss and support caregivers, ensuring sustainable management of MS amid evolving treatment landscapes and demographic shifts.