In their detailed cost of illness study, Cartonet al estimate the total annual costs in their population of 5500 people with multiple sclerosis to be ECU 13 106 000 (£8.7m) for ambulatory care and ECU 26 581 000 (£17.7m) for hospital and institutional care.1

They have adopted a “bottom up” approach which allows costs to be identified for different levels of disability, a distinct advantage from previous “top down” costs of illness studies.2 3

They conclude, as have others,4 that the costs of multiple sclerosis rise with increasing disability and that the information is useful for cost effectiveness studies.

However, to be useful for such studies, the …