The prevalence of MS in the United States: A population-based estimate using health claims data

Mitchell T Wallin, William J Culpepper, Jonathan D Campbell, Lorene M Nelson, Annette Langer-Gould, Ruth Ann Marrie, Gary R Cutter, Wendy E Kaye, Laurie Wagner, Helen Tremlett, Stephen L Buka, Piyameth Dilokthornsakul, Barbara Topol, Lie H Chen, Nicholas G LaRocca, US Multiple Sclerosis Prevalence Workgroup, Mitchell T Wallin, William J Culpepper, Jonathan D Campbell, Lorene M Nelson, Annette Langer-Gould, Ruth Ann Marrie, Gary R Cutter, Wendy E Kaye, Laurie Wagner, Helen Tremlett, Stephen L Buka, Piyameth Dilokthornsakul, Barbara Topol, Lie H Chen, Nicholas G LaRocca, US Multiple Sclerosis Prevalence Workgroup

Abstract

Objective: To generate a national multiple sclerosis (MS) prevalence estimate for the United States by applying a validated algorithm to multiple administrative health claims (AHC) datasets.

Methods: A validated algorithm was applied to private, military, and public AHC datasets to identify adult cases of MS between 2008 and 2010. In each dataset, we determined the 3-year cumulative prevalence overall and stratified by age, sex, and census region. We applied insurance-specific and stratum-specific estimates to the 2010 US Census data and pooled the findings to calculate the 2010 prevalence of MS in the United States cumulated over 3 years. We also estimated the 2010 prevalence cumulated over 10 years using 2 models and extrapolated our estimate to 2017.

Results: The estimated 2010 prevalence of MS in the US adult population cumulated over 10 years was 309.2 per 100,000 (95% confidence interval [CI] 308.1-310.1), representing 727,344 cases. During the same time period, the MS prevalence was 450.1 per 100,000 (95% CI 448.1-451.6) for women and 159.7 (95% CI 158.7-160.6) for men (female:male ratio 2.8). The estimated 2010 prevalence of MS was highest in the 55- to 64-year age group. A US north-south decreasing prevalence gradient was identified. The estimated MS prevalence is also presented for 2017.

Conclusion: The estimated US national MS prevalence for 2010 is the highest reported to date and provides evidence that the north-south gradient persists. Our rigorous algorithm-based approach to estimating prevalence is efficient and has the potential to be used for other chronic neurologic conditions.

Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

Figures

Figure 1. Average annual prevalence of MS…
Figure 1. Average annual prevalence of MS in the United States for 2008, 2009, and 2010 per 100,000 population for private (OP and TH, black lines) and government (Medicaid, Medicare, and VA, red lines) health insurance datasets
Multiple sclerosis (MS) cases acquired from the MS algorithm in year 1 are displayed, along with new cases added cumulatively in subsequent years. OP = Optum; TH = Truven Health; VA = Department of Veterans Affairs.
Figure 2. 2010 Prevalence for MS cumulated…
Figure 2. 2010 Prevalence for MS cumulated over 10 years in the United States per 100,000 population by age and sex
Higher and lower estimates adjusted to 2010 US Census based on combined datasets from the multiple sclerosis (MS) algorithm inclusive of the following: Truven, Optum, Department of Veterans Affairs, Medicare, and Medicaid (full data available for all age and sex estimates in data table e-7 available from Dryad, https://doi.org/10.5061/dryad.pm793v8). (A) Lower-estimate and (B) higher-estimate 2010 MS prevalence in the United States per 100,000 population.
Figure 3. High-estimate 2010 prevalence of MS…
Figure 3. High-estimate 2010 prevalence of MS in the United States per 100,000 population (2010 US Census) by Census region with 95% CI and F:M prevalence ratio
CI = confidence interval; F:M = female:male; MS = multiple sclerosis.

References

    1. Nelson LM, Wallin MT, Marrie RA, et al. . A new way to estimate neurologic disease prevalence in the United States: illustrated with MS. Neurology 2019;92:469–480.
    1. Evans C, Beland SG, Kulaga S, et al. . Incidence and prevalence of multiple sclerosis in the Americas: a systematic review. Neuroepidemiology 2013;40:195–210.
    1. GBD 2015 Neurological Disorders Collaborator Group. Global, regional, and national burden of neurological disorders during 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet Neurol 2017;16:877–897.
    1. Baum HM, Rothschild BB. The incidence and prevalence of reported multiple sclerosis. Ann Neurol 1981;10:420–428.
    1. Anderson DW, Ellenberg JH, Leventhal CM, Reingold SC, Rodrigues M, Silberberg DH. Revised estimate of the prevalence of multiple sclerosis in the United States. Ann Neurol 1992;31:333–336.
    1. Mayr WT, Pittock SJ, McClelland RL, Jorgensen NW, Noseworthy JH, Rodrigues M. Incidence and prevalence of multiple sclerosis in Olmsted County, Minnesota, 1985–2000. Neurology 2003;61:1373–1377.
    1. Marrie RA, Yu N, Blanchard J, Leung S, Elliott L. The rising prevalence and changing age distribution of multiple sclerosis in Manitoba. Neurology 2010;74:464–471.
    1. Kingwell E, Zhu F, Marrie RA, et al. . High incidence and increasing prevalence of multiple sclerosis in British Columbia, Canada: findings from over two decades (1991–2010). J Neurol 2015;262:2352–2363.
    1. Marrie RA, Fisk JD, Stadnyk KJ, et al. . The incidence and prevalence of multiple sclerosis in Nova Scotia, Canada. Can J Neurol Sci 2013;40:824–831.
    1. US Census Bureau. Annual estimates of the resident population for the United States, 2010–2017. Available at: . Accessed July 14, 2018.
    1. US Census Bureau. American community survey. Available at: . Accessed July 14, 2018.
    1. Leonard CE, Brensinger CM, Nam YH, et al. . The quality of Medicaid and Medicare data obtained from CMS and its contractors: implications for pharmacoepidemiology. BMC Health Serv Res 2017;17:304–311.
    1. Culpepper WJ, Marrie RA, Langer-Gould A, et al. . Validation of a Standardized Algorithm for Identifying MS Cases across Claims Datasets. Neurology 2019;92:e1016–e1028.
    1. Reich D, Lucchinetti CF, Calabresi PA. Multiple sclerosis. N Engl J Med 2018;378:169–180.
    1. Ruggles S, Genadek K, Goeken R, Grover J, Sobek M. Integrated public use microdata series: version 6.0. Minneapolis: University of Minnesota; 2015. Available at: 10.18128/D010.V6.0. Accessed July 14, 2018.
    1. Institute of Medicine. Care Without Coverage: Too Little, Too Late. Washington, DC: National Academies Press; 2002. Available at: 10.17226/10367. Accessed July 14, 2018.
    1. Minden SL, Frankel D, Hadden L, Hoaglin DC. Access to health care for people with multiple sclerosis. Mult Scler 2007;13:547–558.
    1. Ng R, Bernatsky S, Rhame E. Observation period effects on estimation of systemic lupus erythematosus incidence and prevalence in Quebec. J Rheumatol 2013;40:1334–1336.
    1. Capocaccia R, Colonna M, Corazziari I, et al. . Measuring cancer prevalence in Europe: the EUROPREVAL project. Ann Oncol 2002;13:831–839.
    1. Noonan CW, Kathman SJ, White MC. Prevalence estimates for MS in the United States and evidence of an increasing trend for women. Neurology 2002;58:136–138.
    1. Campbell JD, Ghushchyan V, Brett McQueen R, et al. . Burden of multiple sclerosis on direct, indirect costs and quality of life: national US estimates. Mult Scler Relat Disord 2014;3:227–236.
    1. Dilokthornsakul P, Valuck RJ, Nair KV, Corboy JR, Allen RR, Campbell JD. Multiple sclerosis prevalence in the United States commercially insured population. Neurology 2016;86:1014–1021.
    1. Gray OM, McDonnell GV, Hawkins SA. Factor in the rising prevalence of multiple sclerosis in the north-east of Ireland. Mult Scler 2008;14:880–886.
    1. Bentzen J, Flachs EM, Stenager E, Bronnum-Hansen H, Koch-Henriksen N. Prevalence of multiple sclerosis in Denmark 1950–2005. Mult Scler 2010;16:520–525.
    1. Kingwell E, Marriott JJ, Gette N, et al. . Incidence and prevalence of multiple sclerosis in Europe: a systematic review. BMC Neurol 2013;13:128.
    1. Gracia F, Castillo LC, Benazdon A, et al. . Prevalence and incidence of multiple sclerosis in Panama (2000–2005). Neuroepidemiology 2009;32:287–293.
    1. Koch-Henriksen, Sorensen PS. The changing demographics of multiple sclerosis epidemiology. Lancet Neurol 2010;9:520–532.
    1. Langer-Gould A, Brara SM, Beaber BE, Zhang JL. Incidence of multiple sclerosis in multiple racial and ethnic groups. Neurology 2013;80:1734–1739.
    1. Wallin MT, Culpepper WJ, Coffman P, et al. . The Gulf War era multiple sclerosis cohort: age and incidence rates by race, sex and service. Brain 2012;135:1778–1785.
    1. Polman CH, Reingold SC, Banwell B, et al. . Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 2011;69:292–302.
    1. Smith-Bindman R, Miglioretti DL, Larson EB. Rising use of diagnostic medical imaging in a large integrated health system. Health Aff 2008;27:1491–1502.
    1. 21st Century Cures Act of 2016. Pub L No. 114-255, section 2061, National Neurological Diseases Surveillance System. 2016.
    1. Amankwah N, Marrie RA, Bancej C, et al. . Multiple sclerosis in Canada 2011 to 2031: results of a microsimulation modelling study of epidemiological and economic impacts. Health Promot Chronic Dis Prev Can 2017;37:37–48.
    1. Kochanek KD, Murphy SL, Xu J, Arias E. Mortality in the United States, 2016. NCHS Data Brief 2017:1–8.
    1. Colby SL, Ortman JM. Projections of the Size and Composition of the U.S. Population: 2014 to 2060, Current Population Reports, P25-1143. Washington, DC: US Census Bureau; 2014.
    1. Guttmann A, Nakhla M, Henderson M, et al. . Validation of a health administrative data algorithm for assessing the epidemiology of diabetes in Canadian children. Pediatr Diabetes 2010;11:122–128.
    1. Ghezzi A, Baroncini D, Zaffaroni M, Comi G. Pediatric versus adult MS: similar or different? Mult Scler Demyelin Disord 2017;2:5.
    1. Benchimol EI, Guttmann A, Griffiths AM, et al. . Increasing incidence of paediatric inflammatory bowel disease in Ontario, Canada: evidence from health administrative data. Gut 2009;58:1490–1497.

Source: PubMed

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