Contributions
Abstract: P637
Type: Poster Sessions
Abstract Category: Therapy - Others
Background: Disease modifying therapies for multiple sclerosis (MS) can decrease health resource utilization (HRU) and delay disease progression. Despite increasing treatment options, many MS patients with access to therapies remain untreated. It is therefore important to understand real-world disease modifying therapy (DMT) utilization patterns among MS patients and their impact on patient outcomes over time.
Objective: To identify continuous DMT users and non-DMT users among commercially insured patients with MS and compare their HRU and disability progression over 5 years.
Methods: A retrospective claims analysis was conducted with the Truven MarketScan Databases. Among continuous enrollees from 2011-2016, MS patients were identified for the index year of 2012 (>2 ICD-9 340 claims, or 1 diagnosis + DMT) and then classified by DMT use. Continuous users included those with >1 DMT claim each year from 2012-2016, while non-DMT users included those with no DMT claims during this period. Propensity score matching was used to balance the cohorts across confounders from the pre-index period/index date (2011-2012), including age, gender, pre-index relapses, comorbidities, and geographic region. We then compared HRU (total, by service type) and disability progression (time to cane/walker, wheelchair) across continuous and non-DMT users.
Results: In total, 15,543 with a diagnosis of MS were identified. Approximately half (51.6%) were continuous users and 22.2% were non-DMT users over the 5 years. 3,407 propensity score matched pairs were identified and included in the analyses. Continuous vs. non DMT users had significantly less total HRU, a significant reduction in inpatient and emergency room utilization, and shorter average hospital stays (p< 0.0001 for all outcomes). Continuous users had a trend toward reduction in time to cane/walker (median: 28.7 vs. 24.2 months) and a significant reduction in time to wheelchair use (median: 25.2 vs. 19.2 months; p< 0.001), in comparison to non-DMT users.
Conclusions: Only half of commercially insured patients were identified as continuous users and a sizeable proportion were not using a DMT, despite widespread availability of and access to effective therapies. Findings suggest continuous DMT use by MS patients reduces HRU, including high cost services (e.g., hospitalizations and ER visits), and slows disease progression. These results highlight the importance of DMT treatment in patients with MS.
Disclosure: This research was funded by Biogen. MW has served on scientific advisory boards, received funding for travel, received speaker honoraria, been a consultant, and/or served on speakers´ bureaus for Biogen, Teva Neuroscience, Bayer, Questcor Pharmaceuticals, EMD Serono, Pfizer, Novartis, Acorda, and Genzyme. LA has served as a consultant to Biogen, Celgene, and Genzyme and receives research funding from Novartis and Biogen. AP, JZ, QH, and TL are employees of, and hold stock and/or stock options in, Biogen.
Abstract: P637
Type: Poster Sessions
Abstract Category: Therapy - Others
Background: Disease modifying therapies for multiple sclerosis (MS) can decrease health resource utilization (HRU) and delay disease progression. Despite increasing treatment options, many MS patients with access to therapies remain untreated. It is therefore important to understand real-world disease modifying therapy (DMT) utilization patterns among MS patients and their impact on patient outcomes over time.
Objective: To identify continuous DMT users and non-DMT users among commercially insured patients with MS and compare their HRU and disability progression over 5 years.
Methods: A retrospective claims analysis was conducted with the Truven MarketScan Databases. Among continuous enrollees from 2011-2016, MS patients were identified for the index year of 2012 (>2 ICD-9 340 claims, or 1 diagnosis + DMT) and then classified by DMT use. Continuous users included those with >1 DMT claim each year from 2012-2016, while non-DMT users included those with no DMT claims during this period. Propensity score matching was used to balance the cohorts across confounders from the pre-index period/index date (2011-2012), including age, gender, pre-index relapses, comorbidities, and geographic region. We then compared HRU (total, by service type) and disability progression (time to cane/walker, wheelchair) across continuous and non-DMT users.
Results: In total, 15,543 with a diagnosis of MS were identified. Approximately half (51.6%) were continuous users and 22.2% were non-DMT users over the 5 years. 3,407 propensity score matched pairs were identified and included in the analyses. Continuous vs. non DMT users had significantly less total HRU, a significant reduction in inpatient and emergency room utilization, and shorter average hospital stays (p< 0.0001 for all outcomes). Continuous users had a trend toward reduction in time to cane/walker (median: 28.7 vs. 24.2 months) and a significant reduction in time to wheelchair use (median: 25.2 vs. 19.2 months; p< 0.001), in comparison to non-DMT users.
Conclusions: Only half of commercially insured patients were identified as continuous users and a sizeable proportion were not using a DMT, despite widespread availability of and access to effective therapies. Findings suggest continuous DMT use by MS patients reduces HRU, including high cost services (e.g., hospitalizations and ER visits), and slows disease progression. These results highlight the importance of DMT treatment in patients with MS.
Disclosure: This research was funded by Biogen. MW has served on scientific advisory boards, received funding for travel, received speaker honoraria, been a consultant, and/or served on speakers´ bureaus for Biogen, Teva Neuroscience, Bayer, Questcor Pharmaceuticals, EMD Serono, Pfizer, Novartis, Acorda, and Genzyme. LA has served as a consultant to Biogen, Celgene, and Genzyme and receives research funding from Novartis and Biogen. AP, JZ, QH, and TL are employees of, and hold stock and/or stock options in, Biogen.