Clinical and economic impact on people with relapsing-remitting multiple sclerosis in the United States: a matched-cohort study

Objectives To understand the real-world clinical and economic impact of relapsing-remitting multiple sclerosis (RRMS) in the United States (US).Methods This retrospective, matched-cohort study used a large, integrated US administrative health database from 01 January 2012 to 31 December 2021. People with RRMS (PwRRMS) were identified using a validated algorithm or through electronic health records and matched 1:1 to MS-free controls based on age, gender, race, region, and insurance. Demographics, comorbidities, healthcare resource utilization (HCRU), and healthcare costs (HCCs) were compared between the RRMS cohort and MS-free controls during 1-year follow-up. All costs were reported in 2021 US dollars.Results The final cohort comprised 9,290 people (RRMS, n = 4,645; MS-free controls, n = 4,645) with a mean ± SD age of 52.9 ± 14.4 years; 79.1% were female. During the follow-up period, compared with the controls, the RRMS cohort had significantly higher prevalence of infections (60.9% vs. 51.5%; p < 0.001) and MS-related comorbidities, including malaise/fatigue (34.3% vs. 15.7%), major depressive disorders (27.6% vs. 17.7%), anxiety (21.4% vs. 15.1%), burning/numbness (19.4% vs. 5.8%), and abnormal gait (16.1% vs. 5.2%) (all p < 0.001). RRMS was associated with significantly higher mortality (5.0% vs. 1.2%), hospitalizations (18.2% vs. 11.5%), emergency department visits (40.3% vs. 28.1%), and physician visits (13.7 vs. 10.0) (all p < 0.001) versus controls. Mean total HCCs were significantly higher for RRMS versus controls ($54,244 vs. $19,671; p < 0.001), driven primarily by medical claims ($31,154 vs. $15,944; p < 0.001).Conclusions PwRRMS experienced a greater impact of comorbidities and significantly increased HCRU and HCCs, highlighting the need to integrate these impacts into everyday clinical decision‑making.