The political-economic sanctions imposed on different countries can have devastating effects on the country's health status, especially on patients with chronic diseases. Given the chronic and debilitating nature of multiple sclerosis, the present study aimed to investigate the relationship of Iran sanctions with the health costs of MS patients in Iran.

This comparative study was conducted on 300 MS patients residing in the East Azerbaijan province of Iran, performed in April-May 2018 (pre-sanctions) and April-May 2019 (post-sanctions). All participants had a health record, and their treatment had started at least one year ago. The study used a validated questionnaire containing demographic/background variables, household income, costs, various imposed costs for accessing healthcare, and patients' perspectives regarding financial pressure by health costs. The rates of catastrophic health expenditures and poverty caused by the disease were calculated based on at least 40% and 50% of non-food costs spent on treatment.

The sanctions increased catastrophic health expenditures by 15% and the poverty index by 14%. In both pre-and post-sanctions phases, such background variables as occupational status, having supplemental insurance, and being native had a significant impact on the amount of out-of-pocket payments, catastrophic health expenditures, or poverty caused by disease costs (p<0.05).

Political-economic sanctions result in widespread negative health impacts against the sanctioned countries' citizens. They lead to increased out-of-pocket payments and decreased ability to pay for patients with multiple sclerosis and households.