Objective To assess the cost of spasticity in MS in the UK.

Methods we conducted a questionnaire survey. We defined five levels of spasticity. Level 1 corresponds to 0–2 on a 10 point Numeric Rating Scale where 0= “no spasticity” and 10= “worst spasticity”. Level 5 corresponded to 9–10 on the same scale. Thirteen UK health professionals active in spasticity management were asked to estimate resource use associated with each level. Resource use frequency was multiplied by UK unit costs to estimate overall burden to the NHS and Personal Social Services. Interviews were performed by telephone and considered only resource use associated with spasticity.

Results The mean (SD) estimate for the annual cost of managing a patient with spasticity was £166 (480), £660 (1381), £2816 (3182), £15 335 (16 382) and £35 663 (30 995) for levels 1–5 respectively. Expenditure on drugs accounted for 8.7% of cost in level 1 but only 0.7% in level 5. Medical consultations and admissions accounted for 90.8% of cost in level 1 and 12.7% in level 5. The remaining costs were due to home modification/equipment and home carers and other professionals. High costs in levels 4 and 5 were driven by home care: mean annual cost of home care was £6591 in level 4 (43% of total cost) and £22 817 in level 5 (64% of total cost).

Conclusions The cost of managing spasticity in MS is high and is concentrated in patients with severe spasticity where intensive home care support is required.