MULTIPLE SCLEROSIS – EPIDEMIOLOGY FORECAST TO 2023 · Multiple sclerosis (MS) affects 2.5 million people worldwide each year and is the most debilitating neurological disease in

REFERENCE CODE GDHCER005-14 | PUBLICAT ION DATE MAY 2014

MULTIPLE SCLEROSIS – EPIDEMIOLOGY FORECAST TO 2023

Multiple Sclerosis – Epidemiology Forecast to 2023 2 © GlobalData. This report is a licensed product and is not to be copied, reproduced, shared or resold in any form.


Executive Summary

Multiple sclerosis (MS) is an inflammatory disease

in which the myelin sheaths around the axons of

the brain and spinal cord are damaged, leading to

demyelination and a wide range of signs and

symptoms (Compston and Coles, 2008). MS

affects 2.5 million people worldwide each year and

is the most debilitating neurological disease in

young adults (Fernandes de Abreu et al., 2009).

The estimated prevalence and incidence of MS

vary greatly between countries, within countries,

and by age and sex. The World Health

Organization (WHO) reports that the median

estimated global prevalence is 30 cases per

100,000 population and the estimated incidence is

approximately 2.5 cases per 100,000 population.

Globally, MS has an average age at onset of 30

years and occurs about twice as frequently in

women as in men (WHO, 2008).

Below mentioned figure presents the prevalent

cases of MS in the 10MM for 2013 and 2023.

10MM, Prevalent Cases of MS, Ages ≥20 Years, Both Sexes, N, 2013 and 2023

12,032

10,025

16,420

38,763

57,399

98,473

110,619

142,085

133,932

285,160

447,339

744,531

904,908

11,162

12,022

17,944

42,820

55,527

104,003

111,184

140,209

142,199

303,343

453,743

768,248

940,413

0 200,000 400,000 600,000 800,000 1,000,000

Japan

India

China

Spain

Italy

UK

France

Germany

Canada

US

5EU

7MM

10MM

Prevalent Cases of MS (N)

Mar

kets

2023

2013

Source: GlobalData; Adssi et al., 2012; Cheng et al., 2007; Hirst et al., 2009; Itoh et al., 2003; Khadilkar et al., 2005; Millefiorini et al., 2010; Noonan et al., 2002; Otero-Romero et al., 2012; Singhal, 1985; USCB, 2013; Warren et al., 2008; WHO, 2008. 5EU = France, Germany, Italy, Spain, and the UK; 7MM = 5EU, the US, and Japan; 10MM = 7MM, Canada, China and India

This report provides an overview of the risk factors

and comorbidities, and global and historical trends

of MS in the 10 major markets (10MM) (the US,

France, Germany, Italy, Spain, the UK, Japan,

Canada, China and India). It includes a 10-year

epidemiological forecast of MS prevalent and

incident cases segmented by sex and age (in five-

year increments beginning at 20 years and ending

at ≥85 years) in the 10MM. GlobalData

epidemiologists used country-specific sources

published by peer-reviewed journals to estimate

the incidence and prevalence of MS in each of the

10MM. To provide a thorough description of the

MS patient population in each country, GlobalData

epidemiologists segmented MS incident and



Executive Summary

prevalent cases by age and sex, both of which

strongly affect the epidemiology of MS. A major

strength of this analysis is that the forecast

methodology was consistent across the 10MM to

allow for a meaningful comparison of the patient

populations in each country.

In 2013, there were a total of 904,908 prevalent

cases of MS in the 10MM, and GlobalData

epidemiologists forecast that by 2023, the number

of prevalent cases will grow to 940,413 cases.

During the forecast period, India will have the

highest annual growth rate (AGR) at 1.99%, Spain

will have the second highest (AGR: 1.05%), and

China will have the third highest (AGR: 0.93%).

Germany, Italy and Japan will see a decrease in

the number of prevalent MS cases by 2023, with

Japan having the largest annual decrease (AGR:

negative 0.72%). By 2023, GlobalData

epidemiologists forecast that the US will have the

highest number of prevalent cases of MS (303,343

prevalent cases), followed by Canada (142,199

prevalent cases) and Germany (140,209 prevalent

cases).

GlobalData epidemiologists forecast that the seven

major markets (7MM) (the US, France, Germany,

Italy, Spain, the UK, and Japan) will see an annual

growth rate of 0.32% during the forecast period,

whereas the five EU markets (5EU) (France,

Germany, Italy, Spain, and the UK) will have an

annual growth rate that is about half that of the

total 7MM (AGR: 0.14%). Of the 5EU markets,

Spain will have the highest annual growth rate of

1.05% and Italy will have the highest annual

decrease of negative 0.33%.

The prevalence and incidence of MS vary greatly

by age, sex and geographical location. Regional

differences in MS prevalence and incidence could

be due to several factors including diagnostic

criteria used, availability of medical technology,

genetic and environmental risk factors, frequency

of comorbidities, and population age and sex

structure.


Table of Contents


1 Table of Contents

1 Table of Contents ....................................................................................................................... 4

1.1 List of Tables ...................................................................................................................... 6

1.2 List of Figures ..................................................................................................................... 6

2 Introduction ................................................................................................................................. 7

2.1 Catalyst ............................................................................................................................... 7

2.2 Related Reports .................................................................................................................. 7

2.3 Upcoming Reports .............................................................................................................. 7

3 Epidemiology .............................................................................................................................. 8

3.1 Disease Background ........................................................................................................... 8

3.2 Risk Factors ........................................................................................................................ 9

3.2.1 Family members of MS patients have a 1%–5% risk of developing MS ........................... 9

3.2.2 Women are twice as likely to develop MS, but men have a worse prognosis................... 9

3.2.3 Caucasians have a higher risk of MS than any other race/ethnicity ............................... 10

3.2.4 Protective effect of vitamin D on MS may relate to latitude and month of birth............... 10

3.2.5 Timing of environmental exposures affects MS risk ....................................................... 11

3.2.6 Exposure to smoking may increase MS risk and worsen prognosis ............................... 11

3.3 Comorbidities .................................................................................................................... 12

3.3.1 Autoimmune diseases may be comorbidities of MS....................................................... 12

3.3.2 Mental comorbidities are found in up to 60% of MS patients and may affect relapse rates ..................................................................................................................................... 12

3.4 Global Trends ................................................................................................................... 13

3.4.1 North America ............................................................................................................... 13

3.4.2 Europe .......................................................................................................................... 14

3.4.3 Asia ............................................................................................................................... 15

3.5 Forecast Methodology ....................................................................................................... 16

3.5.1 Sources Used................................................................................................................ 18


Table of Contents


3.5.2 Sources Not Used ......................................................................................................... 24

3.5.3 Forecast Assumptions and Methods ............................................................................. 24

3.6 Epidemiological Forecast of Multiple Sclerosis (2013–2023) ............................................. 34

3.6.1 Total Prevalent Cases of Multiple Sclerosis ................................................................... 34

3.6.2 Age-Specific Prevalent Cases of Multiple Sclerosis ....................................................... 36

3.6.3 Sex-Specific Prevalent Cases of Multiple Sclerosis ....................................................... 38

3.6.4 Total Incident Cases of Multiple Sclerosis ..................................................................... 40

3.6.5 Age-Specific Incident Cases of Multiple Sclerosis ......................................................... 42

3.6.6 Sex-Specific Incident Cases of Multiple Sclerosis ......................................................... 44

3.6.7 Multiple Sclerosis Subtypes ........................................................................................... 46

3.7 Discussion ........................................................................................................................ 48

3.7.1 Epidemiological Forecast Insight ................................................................................... 48

3.7.2 Limitations of the Analysis ............................................................................................. 49

3.7.3 Strengths of the Analysis ............................................................................................... 49

4 Appendix................................................................................................................................... 50

4.1 Bibliography ...................................................................................................................... 50

4.2 About the Authors ............................................................................................................. 57

4.2.1 Epidemiologists ............................................................................................................. 57

4.2.2 Reviewers ..................................................................................................................... 57

4.2.3 Global Director of Epidemiology .................................................................................... 58

4.2.4 Global Head of Healthcare ............................................................................................ 58

4.3 About GlobalData .............................................................................................................. 59

4.4 About EpiCast ................................................................................................................... 59

4.5 Disclaimer ......................................................................................................................... 60


Table of Contents


1.1 List of Tables

Table 1: Sources of Prevalence and Incidence Data Used in the Epidemiology Forecast ........................... 17

Table 2: 10MM, Prevalent Cases of MS, Ages ≥20 Years, Men and Women, N, Select Years, 2013–2023 35

Table 3: 10MM, Prevalent Cases of MS, By Age, Men and Women, N (Row %), 2013 .............................. 37

Table 4: 10MM, Prevalent Cases of MS, Ages ≥20 Years, By Sex, N (Row %), 2013 ................................ 39

Table 5: 10MM, Incident Cases of MS, Ages ≥20 Years, Men and Women, N, Select Years, 2013–2023 .. 41

Table 6: 10MM, Incident Cases of MS, By Age, Men and Women, N (Row %), 2013 ................................. 43

Table 7: 10MM, Incident Cases of MS, By Sex, N (Row %), 2013 ............................................................. 45

1.2 List of Figures

Figure 1: 10MM, Prevalent Cases of MS, Ages ≥20 Years, Men and Women, N, Select Years, 2013–2023 36

Figure 2: 10MM, Prevalent Cases of MS, By Age, Men and Women, N, 2013 ............................................. 38

Figure 3: 10MM, Prevalent Cases of MS, Ages ≥20 Years, By Sex, N, 2013............................................... 40

Figure 4: 10MM, Incident Cases of MS, Ages ≥20 Years, Men and Women, N, Select Years, 2013–2023 .. 42

Figure 5: 10MM, Incident Cases of MS, By Age, Men and Women, N, 2013 ............................................... 44

Figure 6: 10MM, Incident Cases of MS, By Sex, N, 2013 ............................................................................ 46

Figure 7: 10MM, MS Subtype Distributions, %*, 2013–2023 ....................................................................... 47



Introduction

2 Introduction

2.1 Catalyst

Multiple sclerosis (MS) affects 2.5 million people worldwide each year and is the most debilitating

neurological disease in young adults (Fernandes de Abreu et al., 2009).

GlobalData epidemiologists expect that the number of prevalent and incident cases of MS will

increase during the forecast period (2013–2023) in the 10 major markets (10MM) (the US,

France, Germany, Italy, Spain, the UK, Japan, Canada, China and India).

In 2013, GlobalData epidemiologists forecast that there were a total of 904,908 prevalent

cases of MS in the 10MM, and by 2023 GlobalData epidemiologists forecast that the number of

prevalent cases will grow to 940,413 prevalent cases.

This report provides an overview of the risk factors and comorbidities, and global and historical

trends of MS in the 10MM. It includes a 10-year epidemiological forecast of MS prevalent and

incident cases segmented by sex and age (in five-year increments beginning at 20 years and

ending at ≥85 years) in these markets.

To provide a thorough description of the MS patient population in each country, GlobalData

epidemiologists segmented MS cases by age and sex. Moreover, cases are segmented into

three common sub-types: relapsing-remitting MS, primary progressive MS, and secondary

progressive MS.

A major strength of this analysis is that the forecast methodology was consistent across the

10MM to allow for a meaningful comparison of the patient populations in each country.

2.3 Upcoming Reports

GlobalData (2014) PharmaPoint: Multiple Sclerosis Therapeutics Global Market Forecast and

Market Analysis.


Appendix


4.3 About GlobalData

GlobalData is a leading global provider of business intelligence in the Healthcare industry.

GlobalData provides its clients with up-to-date information and analysis on the latest developments

in drug research, disease analysis, and clinical research and development. Our integrated business

intelligence solutions include a range of interactive online databases, analytical tools, reports and

forecasts. Our analysis is supported by a 24/7 client support and analyst team.

GlobalData has offices in New York, San Francisco, Boston, London, India, Korea, Japan,

Singapore, and Australia.

4.4 About EpiCast

EpiCast is a series of premier epidemiology reports written and developed by Master’s-

and PhD-level epidemiologists.

EpiCast Reports are in-depth, high quality, transparent, and market-driven, providing expert

analysis of epidemiological trends and forecasting of patient populations for major markets.

Specifically, the reports identify disease trends over a 10-year forecast period in six to eight major

markets (US, France, Germany, Italy, Spain, UK, and Japan). Additional countries, such as

Canada, Brazil, China, and India, are covered in these reports if their markets are highly relevant.


Appendix


4.5 Disclaimer

All Rights Reserved.

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any

form by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior

permission of the publisher, GlobalData.

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MULTIPLE SCLEROSIS – EPIDEMIOLOGY FORECAST TO 2023 · Multiple sclerosis (MS) affects 2.5 million people worldwide each year and is the most debilitating neurological disease in