Contributions
Abstract: P400
Type: Poster
Abstract Category: Clinical aspects of MS - 9 Economic burden
Background: Disease modifying treatments (DMTs) for Multiple Sclerosis (MS) have greatly expanded in the last decade. The introduction of more efficacious immunotherapies, different modes of administration and revised diagnostic criteria have shaped the MS landscape. We reviewed the changing landscape of DMTs and subsequent cost implications in a regional centre of a nationally funded health-care system.
Methods: We retrospectively reviewed the records of all patients seen by the East Kent MS service from 2009-2017. All patients receiving DMT were included. Costs were derived by NICE Technology Appraisals.
Results: The East Kent Neurology Unit serves a large geographical area in the East of England with a catchment population of 750,000. The regional prevalence of MS is 210/100,000, with an average of 65 new referrals per year.
A total of 1410 patients with MS are currently in our service, 598 (42%) have relapsing-remitting MS (RRMS). Of those, 389 (65.1%) are receiving DMTs; this represents an increase of 118.6% from 178 patients in 2009.
Over eight years, we have seen a significant decline in the use of interferons from 58.4% (104 patients) of total DMT use in 2009 to 18.5% (72 patients) in 2017. A similar but less steep decline was seen in the use of glatiramer acetate, from 42.8% (86 patients) in 2009 to 18.0% (70 patients) in 2017. In contrast, the use of monoclonal antibodies has significantly increased, from 9 patients (4.5%) in 2009 to 83 (21.3%) in 2017.
The changes in DMT-use has significant cost implications; the total yearly cost of treatment has more than tripled from £1.7 million in 2009 to £6.4 million in 2017. This reflects not only the increased number of RRMS patients eligible for treatment, as the cost per patient has also increased from £8,162 per patient per year in 2009 to £16,324 in 2017.
Conclusion: In our publicly funded neurology unit, treatment for RRMS has significantly changed within the last eight years; use of injectables has substantially reduced, and 1 in 5 patients are receiving monoclonal antibodies. The increased use of highly effective but highly expensive treatments has led to a 6-fold increase in total yearly budget with a yearly cost of £16,324 per patient. Changes in DMTs have significant implications for patients but also health care systems, and with increased DMT costs, judicious use and careful consideration of treatments becomes paramount.
Disclosure:
A. Zarkali: Nothing to disclose
D. Lux: Nothing to disclose
B. Tredwell: Speaker fees from Genzyme
N. Guck: Nothing to disclose
J. Beaumont: Nothing to disclose
I. Redmond: Educational grant from Biogen, Genzyme, Novartis, Serono and Teva.
S. Harikrishnan: Consultancy/speaker fees / Educational grant from Biogen, Genzyme, Novartis, Serono and Teva.
Abstract: P400
Type: Poster
Abstract Category: Clinical aspects of MS - 9 Economic burden
Background: Disease modifying treatments (DMTs) for Multiple Sclerosis (MS) have greatly expanded in the last decade. The introduction of more efficacious immunotherapies, different modes of administration and revised diagnostic criteria have shaped the MS landscape. We reviewed the changing landscape of DMTs and subsequent cost implications in a regional centre of a nationally funded health-care system.
Methods: We retrospectively reviewed the records of all patients seen by the East Kent MS service from 2009-2017. All patients receiving DMT were included. Costs were derived by NICE Technology Appraisals.
Results: The East Kent Neurology Unit serves a large geographical area in the East of England with a catchment population of 750,000. The regional prevalence of MS is 210/100,000, with an average of 65 new referrals per year.
A total of 1410 patients with MS are currently in our service, 598 (42%) have relapsing-remitting MS (RRMS). Of those, 389 (65.1%) are receiving DMTs; this represents an increase of 118.6% from 178 patients in 2009.
Over eight years, we have seen a significant decline in the use of interferons from 58.4% (104 patients) of total DMT use in 2009 to 18.5% (72 patients) in 2017. A similar but less steep decline was seen in the use of glatiramer acetate, from 42.8% (86 patients) in 2009 to 18.0% (70 patients) in 2017. In contrast, the use of monoclonal antibodies has significantly increased, from 9 patients (4.5%) in 2009 to 83 (21.3%) in 2017.
The changes in DMT-use has significant cost implications; the total yearly cost of treatment has more than tripled from £1.7 million in 2009 to £6.4 million in 2017. This reflects not only the increased number of RRMS patients eligible for treatment, as the cost per patient has also increased from £8,162 per patient per year in 2009 to £16,324 in 2017.
Conclusion: In our publicly funded neurology unit, treatment for RRMS has significantly changed within the last eight years; use of injectables has substantially reduced, and 1 in 5 patients are receiving monoclonal antibodies. The increased use of highly effective but highly expensive treatments has led to a 6-fold increase in total yearly budget with a yearly cost of £16,324 per patient. Changes in DMTs have significant implications for patients but also health care systems, and with increased DMT costs, judicious use and careful consideration of treatments becomes paramount.
Disclosure:
A. Zarkali: Nothing to disclose
D. Lux: Nothing to disclose
B. Tredwell: Speaker fees from Genzyme
N. Guck: Nothing to disclose
J. Beaumont: Nothing to disclose
I. Redmond: Educational grant from Biogen, Genzyme, Novartis, Serono and Teva.
S. Harikrishnan: Consultancy/speaker fees / Educational grant from Biogen, Genzyme, Novartis, Serono and Teva.