The cost of spasticty

Stevenson V, Gras A, Bárdos J, Broughton J. The high cost of spasticity in multiple sclerosis to individuals and society. Mult Scler. 2015. pii: 1352458514566416. [Epub ahead of print]

Spasticity is an extremely common, distressing and disabling symptom of multiple sclerosis. Limited data suggest the associated health care costs correlate with increasing severity and place a high economic burden on individuals, health care systems and society.
OBJECTIVE: The aim of this study was to quantify the impact of multiple sclerosis spasticity on health care resources and the associated costs at different levels of severity in people with multiple sclerosis in the United Kingdom.
METHODS:An online survey was carried out to understand the resources used in the management of spasticity in multiple sclerosis. The questionnaire asked health care specialists to estimate their involvement and the resource use associated with different levels of spasticity, and the survey outputs were used to derive the resource costs.
RESULTS: The level and cost of care substantially increased with the degree of spasticity. Key factors contributing to high annual costs per patient were home care, hospital admissions and high-cost items, such as hospital beds.
CONCLUSIONS: Based on the survey results, it can be assumed that managing spasticity early and effectively could result in substantial cost savings, in addition to the improvements in health-related quality of life.

The majority of MSers will get spasticity at some stage during their disease. This can be a painful disabling symptom. There are a number of treatments for this condition but they come with side-effects, notably sedation which means slow uptake or use at night. To help sleep. Baclofen has a problem because it only binds to its target the GABA B receptor with low affinity and so the effect can wear off before 8 hours and so you may not get a good nights sleep or wake up with spasticity or have to set your alarm cloak at night to get up to take a pill. Slow-release formulations to drip feed the drug and have been tried and tested and so far surprisingly failed.

Sativex may help sleep, but we need a treatment for spasticity that does not have the the side effects of the current drugs.

CoI: Yep

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