Open Access Research article

Social participation in patients with multiple sclerosis: correlations between disability and economic burden

Arnaud Kwiatkowski1234*, Jean-Pierre Marissal15, Madani Pouyfaucon6, Patrick Vermersch17, Patrick Hautecoeur124 and Benoît Dervaux13

Author Affiliations

1 PRES Lille Nord de France, Lille, France

2 Department of Neurology, Hôpital Saint Vincent de Paul, Groupement des Hôpitaux de l’Institut Catholique de Lille, Bd de Belfort BP 387, Lille cedex F-59020, France

3 Department of Public Health, Université Lille Nord de France (EA2694), Lille, France

4 Faculté Libre de Médecine, Université Catholique de Lille, Lille, France

5 Faculté Libre des Sciences Economiques et de Gestion, LEM UMR CNRS 8179, Université Catholique de Lille, Lille, France

6 Department of Medicine, Centre Hospitalier d’Hazebrouck, Hazebrouck, France

7 Department of Neurology, Université Lille Nord de France (EA2686), Lille, France

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BMC Neurology 2014, 14:115  doi:10.1186/1471-2377-14-115

Published: 27 May 2014



Economic costs related to treatment of multiple sclerosis (MS) must be justified by health state, quality of life (QOL) and social participation improvement. This study aims to describe correlations between social participation, economic costs, utility and MS-specific QOL in a sample of patients with MS (pwMS).


We interviewed 42 pwMS receiving natalizumab and collected clinical data, direct medical costs, productivity loss, utility (EQ5D-VAS), MS-specific QOL (SEP-59), social participation with the Impact on Participation and Autonomy questionnaire (IPA). We performed descriptive and correlation analyses.


41 pwMS, with a mean Expanded Disability Status Scale (EDSS) score of 4.0, completed questionnaires. Mean annual global cost per patient was 68448 +/-33374 Euros and increased with EDSS (r = 0.644), utility (r = -0.456) and IPA (r = 0.519-0.671) worsening. Mean utility was 0.52 +/- 0.28. Correlations between IPA and QOL (EQ5D-VAS or SEP-59) were observed (r = -0.53 to -0.78). Association between QOL and EDSS was smaller (EQ5D-VAS) or absent. Productivity losses were poorly correlated to EDSS (r = 0.375).


Moderate to strong correlations of social participation with clinical status (EDSS), QOL, utility and economic costs encourage exploring better these links in larger cohorts. The stronger correlation between social participation and QOL than between EDSS and QOL needs to be confirmed.

Multiple sclerosis; Social participation; Economic burden; Quality of life; Natalizumab