Contributions
Abstract: 145
Type: Free Communications
Abstract Category: Clinical aspects of MS - Economic burden
Background: In the clinical course of multiple sclerosis (MS) early treatment initiation is associated with better physical outcomes, both in the short- and long-term. According to the guidelines, disease modifying drugs (DMDs) should be offered as early as possible in the pharmacological management of MS. However, little is known of how treatment decisions affect socio-economic outcomes in patients.
Objectives: The aim of this study was to investigate whether early treatment initiation affects the personal income of MS patients in long-term.
Methods: A prospective cohort study was conducted, of MS patients who started treatment with a DMD during 2001─2012, linking data from the Swedish nationwide registers, including the Multiple Sclerosis Register. A survival analysis was used to measure the association between the time from MS onset to treatment initiation and the outcome, defined as time from treatment initiation to a 95% decrease in annual earnings compared to the each patients' baseline level (at treatment initiation). Additionally, the association between time to treatment and increase of financial compensations from social security systems was investigated.
In total, 3593 MS patients were included in the analysis. Cox regression model was adjusted for gender, age at MS onset, education, family situation, country of birth, and baseline score of the Expanded Disability Status Scale (EDSS).
Results: Patients initiating treatment later had a greater risk of reaching the outcome, e.g., those who started treatment after 2 years from MS onset lost 95% of their earnings sooner with the adjusted hazard ratio of 1.20 (95% confidence interval 1.04─1.38).
Also, female gender, late MS onset, higher baseline EDSS, lower education, being single, and being born outside the European Union had the higher adjusted hazard ratios and were significantly associated with a worse outcome.
On the other hand, risk to receive a certain amount of income from the social benefits (e.g., sickness absence, disability pension) was not different between the early and delayed treatment groups (e.g., the adjusted hazard ratio to reach an annual compensation of SEK 100,000 (≈EUR 10,500) for those who started treatment later was 1.08 (95% confidence interval 0.92─1.26)).
Conclusion: Early treatment initiation was associated with a better outcome, i.e., a lower risk to lose earnings.
Disclosure: Study supported by Biogen.
AK and AM declare that there is no conflict of interest. HG was funded by an unrestricted research grant from Biogen, and is furthermore employed part-time by Statfinn & EPID Research, which is a contract research organisation that performs commissioned pharmacoepidemiological studies and thus its employees have been and currently are working in collaboration with several pharmaceutical companies. KA has received unrestricted research grants from Biogen and from the Swedish Research Council for Working Life, Health and Welfare. JH received honoraria for serving on advisory boards for Biogen and Novartis and speaker´s fees from Biogen, MerckSerono, BayerSchering, Teva and SanofiGenzyme. He has served as P.I. for projects sponsored by, or received unrestricted research support from Biogen, SanofiGenzyme, MerckSerono, TEVA, Novartis and BayerSchering. His MS research is funded by the Swedish Research Council and the Swedish Brain Foundation.
Abstract: 145
Type: Free Communications
Abstract Category: Clinical aspects of MS - Economic burden
Background: In the clinical course of multiple sclerosis (MS) early treatment initiation is associated with better physical outcomes, both in the short- and long-term. According to the guidelines, disease modifying drugs (DMDs) should be offered as early as possible in the pharmacological management of MS. However, little is known of how treatment decisions affect socio-economic outcomes in patients.
Objectives: The aim of this study was to investigate whether early treatment initiation affects the personal income of MS patients in long-term.
Methods: A prospective cohort study was conducted, of MS patients who started treatment with a DMD during 2001─2012, linking data from the Swedish nationwide registers, including the Multiple Sclerosis Register. A survival analysis was used to measure the association between the time from MS onset to treatment initiation and the outcome, defined as time from treatment initiation to a 95% decrease in annual earnings compared to the each patients' baseline level (at treatment initiation). Additionally, the association between time to treatment and increase of financial compensations from social security systems was investigated.
In total, 3593 MS patients were included in the analysis. Cox regression model was adjusted for gender, age at MS onset, education, family situation, country of birth, and baseline score of the Expanded Disability Status Scale (EDSS).
Results: Patients initiating treatment later had a greater risk of reaching the outcome, e.g., those who started treatment after 2 years from MS onset lost 95% of their earnings sooner with the adjusted hazard ratio of 1.20 (95% confidence interval 1.04─1.38).
Also, female gender, late MS onset, higher baseline EDSS, lower education, being single, and being born outside the European Union had the higher adjusted hazard ratios and were significantly associated with a worse outcome.
On the other hand, risk to receive a certain amount of income from the social benefits (e.g., sickness absence, disability pension) was not different between the early and delayed treatment groups (e.g., the adjusted hazard ratio to reach an annual compensation of SEK 100,000 (≈EUR 10,500) for those who started treatment later was 1.08 (95% confidence interval 0.92─1.26)).
Conclusion: Early treatment initiation was associated with a better outcome, i.e., a lower risk to lose earnings.
Disclosure: Study supported by Biogen.
AK and AM declare that there is no conflict of interest. HG was funded by an unrestricted research grant from Biogen, and is furthermore employed part-time by Statfinn & EPID Research, which is a contract research organisation that performs commissioned pharmacoepidemiological studies and thus its employees have been and currently are working in collaboration with several pharmaceutical companies. KA has received unrestricted research grants from Biogen and from the Swedish Research Council for Working Life, Health and Welfare. JH received honoraria for serving on advisory boards for Biogen and Novartis and speaker´s fees from Biogen, MerckSerono, BayerSchering, Teva and SanofiGenzyme. He has served as P.I. for projects sponsored by, or received unrestricted research support from Biogen, SanofiGenzyme, MerckSerono, TEVA, Novartis and BayerSchering. His MS research is funded by the Swedish Research Council and the Swedish Brain Foundation.