Onset-specific health economics of multiple sclerosis

Towards a comprehensive understanding of health economic impact difference between relapse onset multiple sclerosis and progressive onset multiple sclerosis and factors affecting these differences

Degree type


Closing date

18 July 2022



Citizenship requirement


About the research project

Multiple sclerosis (MS) is a complex autoimmune/neurodegenerative disease in which the myelin sheath covering nerve fibres in the central nervous system (brain, optic nerves and spinal cord) is damaged, leading to increasing disability over time, which in turn, negatively impacts individuals’ health-related quality of life (HRQoL) and poses a significant economic burden to patients and society in terms of both direct (healthcare) and indirect costs (from lost productivity). According to the onset type, people with MS can be grouped into the categories of relapse onset MS (ROMS) including relapsing forms of MS (i.e., relapsing remitting MS and secondary progressive MS) and progressive onset MS (PROMS) including primary progressive MS and progressive relapsing MS.

There are clear differences between the two onset types in several aspects including the prevalence, gender ratio, age at onset, disease duration, symptom presentation, disability severity, treatments, and treatment response: resulting in significant health economic impact (i.e.: health state utility [HSU], costs, disability progression and mortality/survival) differences between PROMS and ROMS. Some studies (mostly conducted in Europe and the United States) have estimated the health and economic impacts by MS sub-types.1 However, none of these studies have provided a deep understanding of the differences and factors affecting these differences in onset-specific health economic impacts. Thus, the information on health economic impacts of each MS onset type is needed to evaluate the nature and extent to which these impacts differ by MS onset type, in which patient sub-groups the differences are most pronounced, and what drives these differences. To bridge this substantial research gap, this thesis aims to conduct a range of studies to improve understanding of the nature and extent of inter-onset impact differences and to identify the key drivers of the MS onset specific health economic burden, disability progression and survival/mortality in Australian and similar populations.

The aims of this research thesis are to:

  • Systematically review the international and Australian literature evaluating the health economic impacts of MS by onset type to identify the evidence gaps in this area for Australia.
  • Comprehensively assess the nature and extent of overall and disability severity specific inter-onset health-related quality-of-life differences and factor driving these differences in large representative sample of Australians with MS using six multi-attribute utility instruments to provide implications for healthcare decision-making.
  • Comprehensively assess the nature and extent of overall and disability severity specific inter-onset (direct, indirect, and total) MS-related cost differences and their drivers in a large representative sample of Australians with MS to provide implications for healthcare decision-making.
  • Examine the mobility-based disability trajectories of Australians living with relapse onset MS and progressive onset MS, and identify the factors associated with onset-specific disability trajectories using a group-based modelling approach
  • Estimate age, sex and disability severity specific relative risk of mortality for Australians with each MS onset type compared to Australian population norms, and identify the factors determining onset-specific mortality rates.

The proposed PhD project will use best available data from various surveys of the Australian Multiple Sclerosis Longitudinal Study (AMSLS), and the MSBASE (Neuro-Immunology Registry) cohort.

Primary Supervisor

Meet Prof Andrew Palmer


Applicants will be considered for a Research Training Program (RTP) scholarship or Tasmania Graduate Research Scholarship (TGRS) which, if successful, provides:

  • a living allowance stipend of $28,854 per annum (2022 rate, indexed annually) for 3.5 years
  • a relocation allowance of up to $2,000
  • a tuition fees offset covering the cost of tuition fees for up to four years (domestic applicants only)

If successful, international applicants will receive a University of Tasmania Fees Offset for up to four years.

As part of the application process you may indicate if you do not wish to be considered for scholarship funding.


Applicants should review the Higher Degree by Research minimum entry requirements.

Selection Criteria

The project is competitively assessed and awarded.  Selection is based on academic merit and suitability to the project as determined by the College.

Application process

There is a three-step application process:

  1. Select your project, and check you meet the eligibility and selection criteria;
  2. Contact the Primary Supervisor, Prof Andrew Palmer to discuss your suitability and the project's requirements; and
  3. Submit an application by the closing date listed above.
    • Copy and paste the title of the project from this advertisement into your application. If you don’t correctly do this your application may be rejected.
    • As part of your application, you will be required to submit a covering letter, a CV including 2 x referees and your project research proposal.

Following the application closing date applications will be assessed within the College. Applicants should expect to receive notification of the outcome by email by the advertised outcome date.

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