Use and cost of disease-modifying therapies by Sonya Slifka Studyparticipants: has anything really changed since 2000 and 2009?

• Published in: Multiple sclerosis journal - experimental, translational and clinical translational and clinical, 2019-01, Vol.5 (1)
• Main Authors: Minden, Sarah L, Philip, Kinkel R, Machado, Helene T, Levin, Jonathan S, Rosenthal, Meredith B, Iezzoni, Lisa I
• Format: Article
• Language: English
• Subjects: Costs; Interferon; Multiple sclerosis
• ISSN: 2055-2173
• DOI: 10.1177/2055217318820888

Background Disease-modifying therapies benefit individuals with relapsing forms of multiplesclerosis, but their utility remains unclear for those without relapses. Objective To determine disease-modifying therapy use and costs in 2009, compare use in 2009 and2000, and examine compliance with evidence-based guidelines. Methods We determined the extent and characteristics of disease-modifying therapy use byparticipants in the Sonya Slifka Longitudinal Multiple Sclerosis Study (Slifka) in 2000(n=2156) and 2009 (n=2361) and estimatedout-of-pocket and total (payer) costs for 2009. Two multivariable logistic regressionspredicted disease-modifying therapy use. Results Disease-modifying therapy use increased from 55.3% in 2000 to 61.5% in 2009. In 2009,disease-modifying therapy use was reported by 76.5% of participants withrelapsing-remitting multiple sclerosis, 73.2% with progressive-relapsing multiplesclerosis, 62.5% with secondary progressive multiple sclerosis, and 41.8% with primaryprogressive multiple sclerosis. Use was significantly associated withrelapsing-remitting multiple sclerosis, shorter duration of illness, one to two relapsesper year, non-ambulatory symptoms, using a cane, younger age, higher family income, andhaving health insurance. Average annual costs in 2009 were US$939–3101 for patients andUS$16,302–18,928 for payers. Conclusion Use rates were highest for individuals with relapsing-remitting multiple sclerosis, butsubstantial for those with progressive courses although clinical trials have notdemonstrated significant benefits for them.