BARCELONA — Patients with multiple sclerosis (MS) start to earn less than their non-MS peers around 1 year before they are diagnosed, and by 5 years after diagnosis, they are earning less than three quarters of those unaffected by the condition, new Swedish data show. The loss in earnings is even more pronounced in patients with MS with lower education or who have manual jobs.

The study was presented by Michael Wiberg, MSc, Karolinska Institutet, Stockholm, Sweden, at last week's Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) 2015.

"We found no difference between MS patients and controls 10 years before diagnosis, but by 1 year before diagnosis there was evidence that the MS group were starting to earn less, and the distribution of earnings started to widen. At the time of diagnosis, MS patients were earning 85% of that of their non-MS contemporaries," Wiberg stated.

At 5 years after diagnosis, the patients with MS were earning an average of 72% of the reference group's income. And the difference was greater still in those with lower education or who had manual jobs.

Wiberg suggested that the larger differences in earnings in lower-levels jobs could be due to the nature of the work. "Obviously someone with MS who has a very physical job will be less likely to be able to do it compared with an office-based job. Also, control over working hours may be important, with those with higher education levels more likely to have jobs with flexible working so if they are having a bad few days they can take time off and catch up later," he commented to Medscape Medical News.

But management jobs were an exception to the observation about education levels, with managers who have MS earning 68% of the salary of the non-MS cohort, even though these people will be highly educated. Wiberg suggested that this may be explained by management positions needing more regular, inflexible hours, which patients with MS may find difficult to adhere to.

For the study, Wiberg and colleagues analyzed data on levels and distribution of earnings of patients with MS compared with persons without MS, before and after diagnosis, and whether differences were associated with educational level and type of occupation.

Using national registry data of all Swedish residents in 2004 aged 30 to 54 years, they identified 2556 individuals diagnosed with MS in 2003–2006. These were matched with 7599 people without MS according to sex and age.

Quartiles of earnings, derived from tax office records, were calculated for 16 years, and mean earnings at different levels of education and types of occupation before and after diagnosis were compared.

Results showed increasing differences in levels of earnings between patients with MS and those without MS from 1 year before diagnosis. Also, increasing levels of within-year variation among the patients with MS were observed.

At year of diagnosis, patients with MS had lower mean earnings, with a difference of 28,000 Swedish crowns ($3300). Five years later, the difference was more than twice as large.

Relative Earnings of Patients With MS 5 Years After Diagnosis

Group Percentage of Earnings vs Reference Group
All patients 72
Education  
  Higher 78
  Secondary 68
  Lower 53
Occupation  
  Manager 68
  Office 76
  Manual 65
  Unknown 55
  No work 68

 

Wiberg noted that the researchers looked only at type of occupation in this study, but in future they would like to examine more specifically the type of job environments that allow continued presence in the labor market for patients with MS.

This study was supported by Biogen and the Swedish Research Council for Heath, Working Life, and Welfare. Wiberg is funded by Biogen.

Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) 2015. Abstract 998. Presented October 8, 2015.

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