What is the Multiple sclerosis Treatment Cost in India?
Human brain consists of around 100 billion neurons with each playing a crucial role in the transmission of messaging signals. A nerve protein called myelin facilitates rapid transfer of these signals and coordinates responses between the brain and the body. However, an autoimmune genetic condition leads to destruction of these myelin sheaths. This condition is referred to as multiple sclerosis (MS).
Approximately 2.8 million people globally are estimated to be affected by MS, with around 1.8 lakh individuals in India suffering from the condition.
The average cost of multiple sclerosis treatment in India ranges between INR 10,00,000 to INR 12,00,000 for Indian patients. For international patients, the cost varies between USD 20,000 and 23,000.
What is Multiple Sclerosis?
The central nervous system comprises several nerve cells. Each nerve cell called a neuron, consists of a large cell body and two nerve fibres—an axon for sending impulses and highly branched dendrites for receiving impulses. The axon is surrounded by a protein layer called a myelin sheath. This myelin sheath plays a crucial role in transmitting messages in the form of nerve impulses from the brain to different parts of the body.
Sometimes, due to a genetic disorder, the body's immune cells start attacking the myelin protein present in the neuron. This leads to a condition known as multiple sclerosis (MS). Though the exact reason for MS can't be determined yet, genetic examination has identified changes in the HLA-DRB1 gene as significant risk factors for MS.
Multiple sclerosis is an autoimmune disorder. There is a malfunction of the immune system, which leads to the destruction of the myelin sheath. Any damage caused to this myelin sheath leads to slow or blocked transfer of messages that travel along that nerve fibre.
Symptoms associated with MS can be categorised into the following types:
Primary symptoms
These are the symptoms that begin to appear as soon as the myelin sheath is destroyed.
It includes-
Fatigue
Weakness with shaking (tremors)
Partial loss of vision
Paralysis
Loss of balance
Secondary symptoms
The symptoms followed by primary symptoms are as follows-
Frequent urinary tract infections.
Muscle imbalances
Reduction in bone density
Breathing problems
Increased risk of pneumonia.
Tertiary symptoms
These symptoms start affecting the overall functioning of the patient along with their mental health.
Gait abnormality
Depression
The symptoms associated with MS are progressive. Based on the onset of the symptoms, multiple sclerosis (MS) can be categorised into the following types:
Clinically isolated syndrome (CIS)
This is the primary onset of symptoms which suggest demyelination. There is a 60% chance for a patient with CIS to develop MS at later stages of their lives. Some of the common symptoms seen in CIS include urinary bladder dysfunction, vision problems, and difficulty with coordination.
Relapsing-remitting MS (RRMS)
At this stage, the symptoms of MS define this stage with increased. An estimate suggests that 85% of patients with symptoms of RRMS may develop MS in later stages.
Secondary progressive MS (SPMS)
At this stage, the frequency of onset of symptoms increases. For example, muscle disability decreases, and the patient's neurological function deteriorates. There is no sign of remission even after continuous treatment and therapies.
Primary progressive multiple sclerosis (PPMS)
Once the patient has reached the stage of PPMS, the symptoms gradually worsen, and there are no or very few relapses. The nervous system loses its function due to neurodegeneration and inflammation.
During all these stages, symptoms vary and undergo progressions, making proper diagnosis and prompt treatment necessary.
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What are the Types of Multiple sclerosis Treatment?
There is no specific cure for the treatment of multiple sclerosis (MS). However, haematologists employ some strategies to cure symptoms and minimise complications associated with the onset of symptoms. For short term healing, corticosteroids are employed. In order to achieve long-term healing, following therapeutic approaches are used by the doctors..
Infection-treating therapies
Some symptoms occur as a result of an infection caused by enterotoxins produced by Chlamydia pneumoniae and Staphylococcus aureus. The bacterial infection can be treated with corticosteroids.
In severe cases, doctors may perform plasmapheresis (plasma exchange). It is a therapeutic intervention in which specific antibodies or proteins harmful for the body are removed and replaced. This procedure removed abnormal proteins by 50% thus reducing the symptoms associated with it.
Disease-Modifying Therapies (DMTs):
DMTs is a therapeutic approach which aims to reduce the frequency and severity of symptoms, slow down the disability progression, and decrease inflammation in the brain.
The DMTs employ interferons, glatiramer acetate, and dimethyl fumarate to improve the conditions associated with the symptom.
Symptomatic treatment therapies:
This treatment focuses on managing specific symptoms of MS like pain, imbalance in the body etc..
Medications, physical therapy, occupational therapy, and lifestyle modifications are used to address these symptoms and improve the quality of life.
Rehabilitation Therapies:
Physical therapy, occupational therapy, and speech therapy can help individuals with MS improve mobility, manage daily activities, and maintain independence.
Rehabilitation aims to optimise function and adapt to changes caused by MS.
What are the Key Factors That Affect the Multiple Sclerosis Treatment Cost in India?
Multiple sclerosis causes a long‐term disability burden. Also, the frequency of symptoms varies with the patients. Some may face delayed relapses, whereas for others, they could be quicker. The treatment procedures vary with the onset of symptoms and severity of the medical condition. A patient must be aware of the factors that may affect the cost of multiple sclerosis treatment in India. Some of them are listed below.
Type of Treatment Required
Doctors employ a combination of treatment therapies based on individual needs. Hence, the total cost of multiple sclerosis treatment depends on the type of treatment the patient is undergoing. Medications for MS can vary widely in cost. Advanced technologies such as deep brain stimulation, rhizotomy, if employed, may incur additional costs.
Type of treatment | INR | USD |
|---|---|---|
Modifying therapies | 2,00,000-3,00,000 | 5000-7000 |
Physiotherapy | 7,000-8,000 | 120-140 |
Rehabilitation | 4000-6000 | 65-75 |
Hospital facilities and doctor's expertise
Hospitals equipped with advanced amenities and renowned neurologist and physiotherapists typically incur additional expenses. Moreover, the hospital's reputation and accreditation may impact the overall cost.
Location
Multiple sclerosis treatment costs may vary between cities in India. Metropolitan areas and major cities tend to have higher healthcare costs compared to smaller towns or rural areas. The cost of physiotherapy sessions also differs with the location of the hospital.
Treatment Duration and Frequency
Multiple sclerosis requires lifetime management. The duration of treatment and the frequency of therapies or medications needed to reduce the symptoms can impact the overall cost of treatment.
What are Pre-treatment and Post-treatment Expenses in Multiple sclerosis Treatment?
Multiple sclerosis is a chronic condition, the onset of which is unpredictable and progressive. Some additional medications, along with therapies, are required to maintain the overall health of the patient suffering from MS.
Pre-treatment examination cost (blood tests, lumbar puncture, MRI, sNfL (serum neurofilament), visual evoked response (VER) test, brainstem auditory evoked response (BAER) test, somatosensory evoked response (SSER) test, etc.): INR 15,000 to INR 20,000 (USD 250 to USD 300)
Post-treatment cost( vitamin D supplements, other medications and follow-ups, etc.): INR 3,000 to INR 4,000 (USD 50 to USD 100)
What should be Post-treatment Care after Multiple sclerosis Treatment?
When undergoing treatment therapies, the way patients respond is highly affected by the diet being consumed and the intake of the regular medications to manage symptoms. Some additional care has to be taken by the patient, which includes the following.
Regular medication
Patients undergoing therapies may be suggested some oral and intravenous medications to manage the pain or any specific associated with multiple sclerosis. They must adhere to it as per the doctor’s recommendations.
Regular exercise and a healthy diet
A nutritious diet rich in proteins and whole grains can help deal with symptoms associated with MS. Additionally, based on their individual ability and doctor’s indications, patients can start regular physical activity, which enhances physical strength and flexibility and enhances overall quality of life.
Proper sleep
Lack of sleep can intensify fatigue and impair cognitive function, a common symptom associated with multiple sclerosis (MS). Inadequate sleep can weaken the immune response, leading to increased pain and discomfort. Hence, any discomfort in sleep should be immediately addressed to ensure proper healing.
Does Insurance Cover Multiple sclerosis Treatment in India?
Regular health insurance in India may not cover Multiple sclerosis (MS), but it is usually covered under a critical illness plan. This critical illness plan typically covers several chronic illnesses and includes expenses of stay in a hospital, treatment expenses including therapies, pre and post-hospitalisation charges, ambulance charges, etc. Since regular inflation of medical prices is seen, it’s important to seek a suitable medical plan. In some policies, an insurance policy provides the benefit of no claim bonus. It provides an increased sum of the insured amount at the same premium rate if you don’t raise a claim for a year. Once your neurologist detects symptoms of MS, they start the treatment procedure. Your next step is to submit your doctor’s prescription, investigation reports, and hospital admission papers to the insurance agency along with your policy papers. They will check your eligibility for the claim and collaborate with the hospital to cover your medical expenses as per policy terms.
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Dr. P R Krishnan
Senior Consultant
NeurologistFortis Hospital, Bangalore (Bannerghatta Road)
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