ECTRIMS eLearning

Real-world healthcare resource utilization and treatment switching patterns in multiple sclerosis patients in a large US health plan
Author(s): ,
M Sanchirico
Affiliations:
Sanofi Genzyme, Cambridge, MA
,
I Ma
Affiliations:
Sanofi Genzyme, Cambridge, MA
,
A Caldwell-Tarr
Affiliations:
Comprehensive Health Insights, Louisville, KY, United States
,
L Hashemi
Affiliations:
Sanofi Genzyme, Cambridge, MA
,
P Mudumby
Affiliations:
Comprehensive Health Insights, Louisville, KY, United States
R Dufour
Affiliations:
Comprehensive Health Insights, Louisville, KY, United States
ECTRIMS Learn. Sanchirico M. 09/14/16; 145641; EP1546
Marie Sanchirico
Marie Sanchirico
Contributions
Abstract

Abstract: EP1546

Type: ePoster

Abstract Category: Therapy - disease modifying - Others

Background: There is limited information, such as clinical characteristics and healthcare resource utilization (HCRU), regarding MS patients in the US Medicare programme, a federally subsidized insurance programme. Current treatments aim to prevent relapse and delay disability worsening, to ultimately improve quality of life and limit HCRU. Switching therapy is an important treatment approach to optimize treatment outcomes in MS.

Objective: To retrospectively examine HCRU and disease-modifying therapy (DMT) switching patterns for patients with MS in private (commercial) healthcare and Medicare populations.

Methods: Medical and pharmacy claims from a large US health plan between Jan 1, 2010 and July 31, 2015 were used to identify patients with MS (ICD-9 340). The most recent medical claim for MS during the identification period served as the anchor date. Patients were required to have 12 months of continuous enrolment prior to the anchor date, with demographic and clinical characteristics, and HCRU examined during this period.

Results: A total of 8864 patients (83% Medicare, 17% private) met inclusion criteria. The Medicare population was older than the private population (mean age 57 vs 47 years). Patient demographics were similar in both groups (proportion of female patients [77%], mean unique DMT prescription [1.1], proportion of patients with 2 previously prescribed DMTs [10%] and Deyo-Charlson Comorbidity Index [< 1]). The Medicare population showed a higher MS-specific HCRU than the private population in hospitalization (18% vs 9%), hospital length of stay (7.8 vs 5.8 days) and emergency-room visits (2.3 vs 1.7). MS-specific imaging (mean 4.0) and MRI (mean 2.8) were similar in both populations. Sixty-eight percent of patients received a DMT, and 6.4% of these switched DMT (3.8% to an oral, 1.4% to an injectable, and 1.2% to an infusible therapy). Analysis of switches showed 53.8% of patients switched from an injectable to an oral DMT. Of the total population, 66.5% of patients (Medicare 69%, private 55%), had at least 1 corticosteroid claim.

Conclusion: Despite having a slightly older demographic, the Medicare population presented similar clinical characteristics to the private population. Medicare consumed greater healthcare resources but received no more imaging/MRI services. A low proportion of DMT switching and a high proportion of corticosteroid use may suggest a limited clinical focus on optimizing therapy in both populations.

Disclosure: Study supported by Sanofi Genzyme.

MS: Employee of Sanofi Genzyme.

IM:
Employee of Sanofi Genzyme.

ACT: Nothing to Disclose.

LH: Employee of Sanofi Genzyme.

PM: Nothing to Disclose.

RD:
Nothing to Disclose.



Abstract: EP1546

Type: ePoster

Abstract Category: Therapy - disease modifying - Others

Background: There is limited information, such as clinical characteristics and healthcare resource utilization (HCRU), regarding MS patients in the US Medicare programme, a federally subsidized insurance programme. Current treatments aim to prevent relapse and delay disability worsening, to ultimately improve quality of life and limit HCRU. Switching therapy is an important treatment approach to optimize treatment outcomes in MS.

Objective: To retrospectively examine HCRU and disease-modifying therapy (DMT) switching patterns for patients with MS in private (commercial) healthcare and Medicare populations.

Methods: Medical and pharmacy claims from a large US health plan between Jan 1, 2010 and July 31, 2015 were used to identify patients with MS (ICD-9 340). The most recent medical claim for MS during the identification period served as the anchor date. Patients were required to have 12 months of continuous enrolment prior to the anchor date, with demographic and clinical characteristics, and HCRU examined during this period.

Results: A total of 8864 patients (83% Medicare, 17% private) met inclusion criteria. The Medicare population was older than the private population (mean age 57 vs 47 years). Patient demographics were similar in both groups (proportion of female patients [77%], mean unique DMT prescription [1.1], proportion of patients with 2 previously prescribed DMTs [10%] and Deyo-Charlson Comorbidity Index [< 1]). The Medicare population showed a higher MS-specific HCRU than the private population in hospitalization (18% vs 9%), hospital length of stay (7.8 vs 5.8 days) and emergency-room visits (2.3 vs 1.7). MS-specific imaging (mean 4.0) and MRI (mean 2.8) were similar in both populations. Sixty-eight percent of patients received a DMT, and 6.4% of these switched DMT (3.8% to an oral, 1.4% to an injectable, and 1.2% to an infusible therapy). Analysis of switches showed 53.8% of patients switched from an injectable to an oral DMT. Of the total population, 66.5% of patients (Medicare 69%, private 55%), had at least 1 corticosteroid claim.

Conclusion: Despite having a slightly older demographic, the Medicare population presented similar clinical characteristics to the private population. Medicare consumed greater healthcare resources but received no more imaging/MRI services. A low proportion of DMT switching and a high proportion of corticosteroid use may suggest a limited clinical focus on optimizing therapy in both populations.

Disclosure: Study supported by Sanofi Genzyme.

MS: Employee of Sanofi Genzyme.

IM:
Employee of Sanofi Genzyme.

ACT: Nothing to Disclose.

LH: Employee of Sanofi Genzyme.

PM: Nothing to Disclose.

RD:
Nothing to Disclose.



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