In response to your comments about the prognosis and severity of MS. There is no doubt in my mind that MS is a disabling disease and leads to disability in the majority of subjects given sufficient time. However, this statement refers to the prognosis from natural history studies done in the the pre-DMT era. I believe that in the current era with aggressive treatment early on the prognosis has improved.
The following figure demonstrates UK Society's perspective on the disease. On the y-axis is utility an index of quality of health used by health economists; 1 is perfect quality of health and 0 is death. Your utility on the day you are born is 1 and gradually drops to 0 when you die. A value less than 0 is considered a quality of life worse than death. It is alarming that in the UK a PwMS with an EDSS of 8.0 or 9.0 (weakness in all 4 limbs and/or bed-bound) is considered to have a quality of life worse than death. I am told that no other chronic disease scores this low. Alarming?

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