The Economic and societal burden of multiple sclerosis on lebanese society: a cost-of-illness and quality of life study protocol

J. Dahham*, R. Rizk, M. Hiligsmann, C. Daccache, S.J. Khoury, H. Darwish, S. Evers, I. Kremer

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


This protocol describes the estimation of the societal costs and quality-of-life (QOL) burden of multiple sclerosis (MS) in Lebanon. This cross-sectional, prevalence-based burden-of-illness study was carried out in a premier MS center in Lebanon. We enrolled Lebanese patients aged 18 years and older who had been diagnosed with MS more than 6 months. The study uses a bottom-up approach to estimate the cost-of-illness (COI) and QOL using a retrospective face-to-face interview questionnaire. This resource utilization questionnaire was adapted to the Lebanese context by clinical and health economics experts. The methodologies used to estimate the consumption of healthcare resources, informal care, and productivity losses are well-defined and aligned with the Lebanese healthcare system. Costs are presented overall and by MS severity levels. QOL is measured using the EuroQOL (EQ-5D-5 L) and Multiple Sclerosis International Quality of Life (MusiQoL) instrument. This protocol pioneers in informing the design of future COI and QOL studies in low - and middle-income countries (LMICs), as the methods used could be applied in similar LMICs. Furthermore, we provide recommendations and discuss the challenges of conducting a high-quality burden-of-illness study in LMICs and the steps taken to meet them, using the case of Lebanon.
Original languageEnglish
Pages (from-to)869-876
Number of pages8
JournalExpert Review of Pharmacoeconomics & Outcomes Research
Issue number5
Early online date27 Nov 2021
Publication statusPublished - 4 Jul 2022


  • Cost-of-illness
  • economic burden
  • Lebanon
  • multiple sclerosis
  • study protocol
  • utilities
  • MS
  • EQ-5D

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