Long-term economic and welfare consequences of Ménière's disease: a Danish nationwide matched cohort study, 2002-2016

PURPOSE: To assess the long-term economic and welfare burden of Ménière's disease, focusing on healthcare costs, income, and reliance on social benefits before and after the first hospital-recorded diagnosis.

METHODS: We conducted a nationwide matched cohort study in Denmark, involving 5,434 patients with a hospital-recorded Ménière's disease diagnosis later confirmed by an otorhinolaryngologist and 16,302 matched controls based on age, sex, civil status, municipality, and index year defined by the first hospital registration of Ménière's disease. The mean age was 59 years, and 56% were females. The study assessed outcomes such as annual healthcare costs, income disparities, and social benefit receipt from ten years prior to ten years after diagnosis.

RESULTS: Annual healthcare costs were higher in patients with Ménière's disease after diagnosis, peaking at index year (EUR 3,818 vs. EUR 1,862 in controls). Patients with Ménière's disease also showed a sustained decline in annual income, with the largest decline at year 8 after diagnosis (EUR - 1.908 compared to controls). At index year, 11% of patients transitioned to sickness benefits (vs. 3% of controls). From index year to 120 months post-diagnosis, disability pension rates increased from 10% to 18% in patients with Ménière's disease, whereas they remained almost stable going from 10% to 9% among controls. Similarly, participation in the flexible job scheme rose from 4% to 10% in Ménière's disease compared with 2% to 4% in controls.

CONCLUSION: Ménière's disease was associated with persistently higher healthcare costs, reduced income, and greater reliance on social benefits compared with matched controls, particularly evident around and after the time of diagnosis. These findings highlight the substantial long-term economic and welfare burden of the disease.