attributed medical cost of annual multiple sclerosis relapses in iran related to exposure of ambient air particulate matter

Multiple sclerosis (ms) imposes a substantial burden on the healthcare system and society. in addition, air pollution has a high economic burden in terms of health impacts. there is growing evidence that associates the ms onset and relapse with environmental factors, including ambient air particulate matters (pm). the objective of this study was to estimate the additional direct medical costs of ms relapses related to pm exposure within a one-year timeframe in iran. the cost of relapse management was estimated from the healthcare system perspective. using the relevant relapse probabilities associated with pm reduction, the incremental total cost was estimated and reported as a saving cost from pm reduction. the calculated direct medical cost for managing mild relapses was 9.90 (us dollars) usd per episode, and the average costs for moderate and severe relapses were 115.17 and 515.48 usd per episode, respectively. in iran, relapse management in relapsing-remitting ms (rrms) patients was estimated to cost 5,365,896 usd per year. a reduction of pm per 10 μg/m³ could result in an average cost savings of 13.84 usd per rrms patient in a given year and an average annual cost savings of 1,041,279 usd for all patients with rrms, equal to a reduction of 19.40% of ms relapse management costs. these findings will assist policymakers in developing well-informed decisions to improve public health outcomes, including the quality of life of ms patients, besides decreasing healthcare costs.