Evidence mapPaperPMID 39095665Full record

ArticlePharmacoEconomics2025

Estimation of Transition Probabilities from a Large Cohort (> 6000) of Australians Living with Multiple Sclerosis (MS) for Changing Disability Severity Classifications, MS Phenotype, and Disease-Modifying Therapy Classifications.

Julie A Campbell, Glen J Henson, Valery Fuh Ngwa, Hasnat Ahmad, Bruce V Taylor, Ingrid van der Mei, MSBase Australian Researchers, Andrew J Palmer

Erratum issuedAbstract read
In one paragraph

Article in PharmacoEconomics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Julie A Campbell *Medical Sciences Precinct, Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia. Julie.Campbell@utas.edu.au.ORCID http://orcid.org/0000-0002-1820-6758
Glen J Henson *Medical Sciences Precinct, Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.ORCID http://orcid.org/0000-0002-1237-5710
Valery Fuh NgwaMedical Sciences Precinct, Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.ORCID http://orcid.org/0000-0001-7531-7246
Hasnat AhmadMedical Sciences Precinct, Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.ORCID http://orcid.org/0000-0002-2580-9856
Bruce V TaylorMedical Sciences Precinct, Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.ORCID http://orcid.org/0000-0003-2807-0070
Ingrid van der MeiMedical Sciences Precinct, Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.ORCID http://orcid.org/0000-0001-9009-7472
MSBase Australian Researchers
Andrew J PalmerMedical Sciences Precinct, Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia. Andrew.Palmer@utas.edu.au.ORCID http://orcid.org/0000-0002-9703-7891

Funding

Australian Government MRFF EPCD000008MS Australia 19-0702
6 · The paper itself

Abstract

backgroundMultiple sclerosis (MS) is a chronic autoimmune/neurodegenerative disease associated with progressing disability affecting mostly women. We aim to estimate transition probabilities describing MS-related disability progression from no disability to severe disability. Transition probabilities are a vital input for health economics models. In MS, this is particularly relevant for pharmaceutical agency reimbursement decisions for disease-modifying therapies (DMTs).

methodsData were obtained from Australian participants of the MSBase registry. We used a four-state continuous-time Markov model to describe how people with MS transition between disability milestones defined by the Expanded Disability Status Scale (scale 0-10): no disability (EDSS of 0.0), mild (EDSS of 1.0-3.5), moderate (EDSS of 4.0-6.0), and severe (EDSS of 6.5-9.5). Model covariates included sex, DMT usage, MS-phenotype, and disease duration, and analysis of covariate groups were also conducted. All data were recorded by the treating neurologist.

resultsA total of N = 6369 participants (mean age 42.5 years, 75.00% female) with 38,837 person-years of follow-up and 54,570 clinical reviews were identified for the study. Annual transition probabilities included: remaining in the no, mild, moderate, and severe states (54.24%, 82.02%, 69.86%, 77.83% respectively) and transitioning from no to mild (42.31%), mild to moderate (11.38%), and moderate to severe (9.41%). Secondary-progressive MS was associated with a 150.9% increase in the hazard of disability progression versus relapsing-remitting MS.

conclusionsPeople with MS have an approximately 45% probability of transitioning from the no disability state after one year, with people with progressive MS transitioning from this health state at a much higher rate. These transition probabilities will be applied in a publicly available health economics simulation model for Australia and similar populations, intended to support reimbursement of a plethora of existing and upcoming interventions including medications to reduce progression of MS.

Indexed as

Models, EconomicMultiple SclerosisAdultAustralasian PeopleAustraliaCohort StudiesDisability EvaluationDisease ProgressionFemaleHumansMaleMarkov ChainsMiddle AgedPersons with DisabilitiesPhenotypeProbability

Identifiers

PMID39095665
PMCPMC11782298

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.