Financial burden of out of pocket nonpharmacological therapies in an Austrian multiple sclerosis cohort

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Abstract
Given the financial constraints in public healthcare, we investigated the monthly out-of-pocket expenses for non-pharmacological treatments among individuals with multiple sclerosis (MS), a chronic neurological disorder that primarily affects individuals of working age. This cross-sectional study employed an online questionnaire to evaluate the expenses and utilization of non-pharmacological treatments, as well as the weekly working hours among 104 individuals with relapsing-remitting MS (RRMS, 79%), secondary progressive MS (SPMS, 12%), and primary progressive MS (PPMS, 10%). Non-pharmacological treatments were used by 82% of participants (vitamin D (43%), physiotherapy (31%), massage (21%), magnesium (19%)). The average monthly out-of-pocket expenses were 136 EUR (SD ± 218) and significantly higher among individuals with PPMS (337 EUR SD ± 354) compared to RRMS (110 EUR SD ± 195; p = 0.01). The average weekly working hours were 26 and significantly lower among individuals with PPMS (11 h/week, SD ± 16; p = 0.008) and SPMS (13 h/week, SD ± 16; p = 0.001) compared to the RRMS cohort (30 h/week, SD ± 15). Working hours were not related to individual monthly costs. This study reveals substantial expenses incurred by individuals with MS in Austria, particularly those with PPMS, highlighting the willingness to actively participate in their disease management. Physicians should be aware of the financial resources and inform about available evidence on non-pharmacological treatment approaches.

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