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The mission of the Harvey L. Neiman Health Policy Institute® is to establish foundational evidence for health policy and radiology practice that promotes the effective and efficient use of health care resources and improves patient care.

September 8, 2020

New Study Reveals 75% of Multiple Sclerosis Patients Face Financial Toxicity

Reston, VA  – A new study from Harvey L. Neiman Health Policy Institute finds that over ¾ of Multiple Sclerosis (MS) patients face financial toxicity (hardship) that often results in non-adherence to follow up care. This Multiple Sclerosis Journal study is the first of its kind to evaluate financial toxicity in MS patients and whether financial hardship is linked to patients foregoing the therapy and imaging follow-up prescribed in their treatment plan.

Finance toxicity measures how out-of-pocket costs of treatment can impact patients material conditions such as medical debt and bankruptcy, results in financial worry and coping behaviors such as non-adherence to care and lifestyle changes to offset costs. MS patients specifically face considerable financial hardship due to the expensive treatments, high rates of disability and lost income.

“Over the last 20 years, higher out-of-pocket costs for advanced imaging tests and increased cost sharing have caused the financial burdens on MS patients to escalate. Among medically bankrupt families, MS is associated with the highest total out of-pocket expenditures exceeding those of cancer patients,” said lead author Gelareh Sadigh, MD, assistant radiology professor at Emory University School of Medicine. “Our study results demonstrate the high prevalence of financial toxicity for MS patients and the resulting decisions patients make that impact their health care and lifestyle.”

Dr. Sadigh and team surveyed 243 adult MS patients visiting neurology clinics. Overall, 56% of patients reported decreases in income after their MS diagnosis, with 37% experiencing a decrease greater than 20%. In response to care non-adherence, 35% reported medication or imaging non-adherence due to treatment expenses with 13% reporting non-receipt of recommended imaging tests, which have higher co-payments than other health care services.1

“These data underscore the need for shared decision-making and an awareness of patient financial strain when planning treatment strategies,” said co-author and Neiman Institute affiliate senior research fellow, Richard Duszak, MD, FACR, professor and vice chair for health policy and practice in the department of radiology and imaging sciences at Emory University . “In addition to the impact on adherence, financial toxicity was associated with significantly lower physical health-related quality of life (HRQOL), demonstrating the broad consequences of treatment costs for many MS patients.”

[1] Rosenkrantz, AB, Sadigh, G, Carlos, RC, Silva, E, and Duszak, R. Out-of-Pocket Costs for Advanced Imaging Across the US Private Insurance Marketplace. J Am Coll Radiol 2018;15:607-614.


To obtain a copy of the study or to arrange an interview with a Neiman Institute spokesperson, contact Nichole Gay at (703) 648-1665 or


About the Harvey L. Neiman Health Policy Institute

The Harvey L. Neiman Health Policy Institute® is one of the nation’s leading medical imaging socioeconomic research organizations. The Neiman Institute studies the role and value of radiology and radiologists in evolving health care delivery and payment systems and the impact of medical imaging on the cost, quality, safety and efficiency of health care.Visit us at and follow us on Twitter, LinkedIn and Facebook.


Nichole Gay
Harvey L. Neiman Health Policy Institute