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Real-World Treatment of Patients with Multiple Sclerosis per MS Subtype and Associated Healthcare Resource Use: An Analysis Based on 13,333 Patients in Germany

Authors :
Andreas Fuchs
Gunter Ladinek
Thomas Wilke
Andreas Pfaff
Kathrin Ernst
Tobias Heidler
Sabrina Müller
Source :
Neurology and Therapy, Vol 9, Iss 1, Pp 67-83 (2019), Neurology and Therapy
Publication Year :
2019
Publisher :
Springer Science and Business Media LLC, 2019.

Abstract

Introduction The aim of this study was to describe the real-word treatment and associated healthcare resource use (HCRU) of multiple sclerosis (MS) patients, as stratified by different MS subtypes. Methods All patients with MS continuously insured by two German statutory healthcare insurance funds from 2011 to 2015 were enrolled. These patients were categorized into four subgroups according to their MS type as follows: clinically isolated syndrome (CIS); relapsing remittent MS (RRMS); primary progressive MS (PPMS); and secondary progressive MS (SPMS). Sociodemographic characteristics, treatments, and HCRU for 2015 were analyzed. Treatment cascades for treatment-naïve patients were also determined. Results A total of 13,333 patients with MS were identified. The largest proportion of patients had RRMS (41.9%), followed by PPMS (17.1%). Mean age of the enrolled patients was 50.2 years, and 70.7% were female. Among all patients, 38.3% of those with CIS, 22.4% with PPMS, 69.6% with RRMS, and 33.9% with SPMS received a prescription of a disease-modifying immunomodulatory agent, with interferon beta-1a being the most frequently prescribed agent. Likewise, 14.5, 18.5, 19.9, and 21.5% of patients with CIS, PPMS, RRMS, and SPMS, respectively, received a flare-up treatment with glucocorticoids. MS-associated overall costs, including indirect costs for MS-associated days absent from work, were € 16,433, with costs related to MS medication (€ 8770; 53.4%) being the main driver of costs in all subgroups. MS-associated costs according to MS subtypes were € 12,427 for CIS patients, € 14,459 for PPMS patients, € 20,583 for RRMS patients, and € 17,554 for SPMS patients. Conclusion Among the four MS subtypes, RRMS patients most often received a disease-modifying immunomodulatory treatment. Consequently, healthcare costs were highest for patients with this MS subtype. Contrary to the treatment guideline, a substantial percentage of patients with CIS, RRMS, and SPMS did not receive any disease-modifying immunomodulatory treatment. Electronic Supplementary Material The online version of this article (10.1007/s40120-019-00172-5) contains supplementary material, which is available to authorized users.

Details

ISSN :
21936536 and 21938253
Volume :
9
Database :
OpenAIRE
Journal :
Neurology and Therapy
Accession number :
edsair.doi.dedup.....9d857b27c45a9a34d146f46542c01a0d
Full Text :
https://doi.org/10.1007/s40120-019-00172-5