Contributions
Abstract: P374
Type: Poster
Abstract Category: Clinical aspects of MS - Economic burden
Background: Pharmacological management of relapsing-remitting multiple sclerosis (RRMS) includes the use of oral, injectable, or infusible Disease Modifying Therapies (DMTs). Optimal treatment in MS requires adherence to medication administration schedule.
Objective: To assess compliance and discontinuation rates with DMTs in Canadian patients with RRMS.
Methods: In this Canadian retrospective claims analysis based on IMS Rx Dynamics® database, patients had ≥1 prescription filled for each DMT (oral: fingolimod, dimethyl fumarate (DMF), teriflunomide; injectable (BRACE): interferon beta-1a, interferon beta-1b, glatiramer acetate; infusible: natalizumab). Patients were considered compliant if the medication possession ratio (MPR) was ≥80%. Discontinuation rates were calculated based on patients who stopped therapy (60 day window) or who were switched to another DMT. Compliance and discontinuation rates were collected for a 6-month period and discontinuation for 12 and 24-month periods (cohorts from 2012-2015, rolling 36 months total).
Results: Compliance data was collected for 11448 patients (fingolimod, n=1476; DMF, n=2900; teriflunomide, n=1113; natalizumab, n=589; BRACE, n=5370). The percentage of patients deemed compliant after 6 months across Canada was higher for fingolimod (77%), compared to natalizumab (69%), DMF (62%), and BRACE (55%) and comparable to teriflunomide (77%). Patients on fingolimod had the lowest discontinuation rate after 6, 12 and 24-month periods (24%, 21%, 26% respectively) compared to: BRACE (48%, 42%, and 58%); natalizumab (34%, 30%, and 53%) and DMF (27%, 29% and 36%); and similar to teriflunomide at 6 and 12-month periods (24% and 23%), 24-month data was not available.
Conclusions: The percentage of patients deemed compliant and treated with fingolimod was similar to teriflunomide, but higher than for other DMTs. The discontinuation rate was similar to teriflunomide, but lower compared to other DMTs over the short-term. Unlike other DMTs, the discontinuation rate with fingolimod did not significantly increase over the 24-month period. These findings may inform MS management strategies which may lead to improved clinical and economic outcomes. Findings based in part on data licensed from IMS Health Canada Inc. All Rights Reserved.
Disclosure:
Pierre Duquette - Has received honoraria for advisory boards, for CMEs from Novartis, Biogen-Idec, Genzyme, EMD Serono and Teva Neurosience. He has taken part in Investigator-initiated trials funded by Novartis, Biogen-Idec, Genzyme and EMD Serono and has received funding from peer-reviewed agencies such as the Canadian Institutes for Health Research (CIHR) and the MS Society of Canada.
Donald Rivest - Has received honoraria for consulting and advisory board participation from Biogen-Idec, Bayer, Novartis, Genzyme, EMD Serono and Teva Innovation. He has acted as site principal investigator for clinical trials for Biogen, EMD Serono and Novartis.
Virginia Devonshire - Has received honoraria for advisory meetings and speaker honorarium from EMD Serono, Biogen-Idec, Teva Neurosciences, Novartis, Allergan and Genzyme. UBC has received payments for clinical trials in which Dr. Devonshire was the Principal Investigator from Novartis, Serono, and Genzyme.
Virender Bhan - Has received honoraria for speaking, consulting, and advisory board participation from Biogen-Idec, EMD Serono, Genzyme, Novartis, Roche and Teva Neuroscience. He has acted as site principal investigator for clinical trials for Biogen-Idec, EMD Serono, Novartis, Sanofi-Aventis and Teva Neuroscience.
Daniel Selchen - Has received honoraria for speaking, consulting and advisory board participation from Teva Innovation, Merck Serono, Genzyme, Novartis, Biogen-Idec, Bristol-Myers Squibb and Boehringer Ingelheim.
Michael Yeung - Has received consultation fees from EMD Serono, Genzyme and Novartis, the Canadian Agency for Drugs and Technologies in Health (CADTH)/Health Canada, and research support from Biogen-Idec, Genzyme, Hoffmann-La Roche, Novartis, and Teva Canada Innovation.
Robyn Schecter - Employee of Novartis Pharmaceuticals Canada Inc.
Paola Haddad - Employee of Novartis Pharmaceuticals Canada Inc.
Abstract: P374
Type: Poster
Abstract Category: Clinical aspects of MS - Economic burden
Background: Pharmacological management of relapsing-remitting multiple sclerosis (RRMS) includes the use of oral, injectable, or infusible Disease Modifying Therapies (DMTs). Optimal treatment in MS requires adherence to medication administration schedule.
Objective: To assess compliance and discontinuation rates with DMTs in Canadian patients with RRMS.
Methods: In this Canadian retrospective claims analysis based on IMS Rx Dynamics® database, patients had ≥1 prescription filled for each DMT (oral: fingolimod, dimethyl fumarate (DMF), teriflunomide; injectable (BRACE): interferon beta-1a, interferon beta-1b, glatiramer acetate; infusible: natalizumab). Patients were considered compliant if the medication possession ratio (MPR) was ≥80%. Discontinuation rates were calculated based on patients who stopped therapy (60 day window) or who were switched to another DMT. Compliance and discontinuation rates were collected for a 6-month period and discontinuation for 12 and 24-month periods (cohorts from 2012-2015, rolling 36 months total).
Results: Compliance data was collected for 11448 patients (fingolimod, n=1476; DMF, n=2900; teriflunomide, n=1113; natalizumab, n=589; BRACE, n=5370). The percentage of patients deemed compliant after 6 months across Canada was higher for fingolimod (77%), compared to natalizumab (69%), DMF (62%), and BRACE (55%) and comparable to teriflunomide (77%). Patients on fingolimod had the lowest discontinuation rate after 6, 12 and 24-month periods (24%, 21%, 26% respectively) compared to: BRACE (48%, 42%, and 58%); natalizumab (34%, 30%, and 53%) and DMF (27%, 29% and 36%); and similar to teriflunomide at 6 and 12-month periods (24% and 23%), 24-month data was not available.
Conclusions: The percentage of patients deemed compliant and treated with fingolimod was similar to teriflunomide, but higher than for other DMTs. The discontinuation rate was similar to teriflunomide, but lower compared to other DMTs over the short-term. Unlike other DMTs, the discontinuation rate with fingolimod did not significantly increase over the 24-month period. These findings may inform MS management strategies which may lead to improved clinical and economic outcomes. Findings based in part on data licensed from IMS Health Canada Inc. All Rights Reserved.
Disclosure:
Pierre Duquette - Has received honoraria for advisory boards, for CMEs from Novartis, Biogen-Idec, Genzyme, EMD Serono and Teva Neurosience. He has taken part in Investigator-initiated trials funded by Novartis, Biogen-Idec, Genzyme and EMD Serono and has received funding from peer-reviewed agencies such as the Canadian Institutes for Health Research (CIHR) and the MS Society of Canada.
Donald Rivest - Has received honoraria for consulting and advisory board participation from Biogen-Idec, Bayer, Novartis, Genzyme, EMD Serono and Teva Innovation. He has acted as site principal investigator for clinical trials for Biogen, EMD Serono and Novartis.
Virginia Devonshire - Has received honoraria for advisory meetings and speaker honorarium from EMD Serono, Biogen-Idec, Teva Neurosciences, Novartis, Allergan and Genzyme. UBC has received payments for clinical trials in which Dr. Devonshire was the Principal Investigator from Novartis, Serono, and Genzyme.
Virender Bhan - Has received honoraria for speaking, consulting, and advisory board participation from Biogen-Idec, EMD Serono, Genzyme, Novartis, Roche and Teva Neuroscience. He has acted as site principal investigator for clinical trials for Biogen-Idec, EMD Serono, Novartis, Sanofi-Aventis and Teva Neuroscience.
Daniel Selchen - Has received honoraria for speaking, consulting and advisory board participation from Teva Innovation, Merck Serono, Genzyme, Novartis, Biogen-Idec, Bristol-Myers Squibb and Boehringer Ingelheim.
Michael Yeung - Has received consultation fees from EMD Serono, Genzyme and Novartis, the Canadian Agency for Drugs and Technologies in Health (CADTH)/Health Canada, and research support from Biogen-Idec, Genzyme, Hoffmann-La Roche, Novartis, and Teva Canada Innovation.
Robyn Schecter - Employee of Novartis Pharmaceuticals Canada Inc.
Paola Haddad - Employee of Novartis Pharmaceuticals Canada Inc.