Impact of medication adherence to disease-modifying drugs on severe relapse, and direct and indirect costs among employees with multiple sclerosis in the US

Ivanova, Jasmina I.; Bergman, Rachel; Birnbaum, Howard G.; Phillips, Amy; Stewart, Michelle; Meletiche, DM

doi:10.3111/13696998.2012.667027

Cited by 102 publications

(109 citation statements)

References 33 publications

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“…Several studies have shown that adherence to, and persistence with, DMTs are associated with a reduced risk of relapse 22,23 , reduced healthcare resource utilization 22 , reduced incidence of MS-related hospitalization 19 , and improved health-related quality-of-life 24,25 in patients with MS. First-line injectable DMTs are associated with sub-optimal rates of adherence and persistence 20,22,[26][27][28][29] , and treatment-related issues, such as unresponsiveness and intolerance to GA or IFNs, prompt patients to discontinue or switch therapy 30,31 . A review of DMT discontinuation rates across several countries found that 16-27% of patients discontinued GA or IFN therapy prematurely within 24 months of follow-up, increasing to 43% for GA and up to 34% for IFNs when patients were followed for longer than 24 months 32 .…”

Section: Introductionmentioning

confidence: 99%

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Persistence with and adherence to fingolimod compared with other disease-modifying therapies for the treatment of multiple sclerosis: a retrospective US claims database analysis

Bergvall

Petrilla

Karkare

et al. 2014

Journal of Medical Economics

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Objective: Achieving therapeutic goals in multiple sclerosis (MS) requires strict adherence to treatment schedules. This retrospective study analyzed persistence with, and adherence to, fingolimod compared with injectable/ infusible disease-modifying therapies (DMTs) in patients with MS. Methods:Patients in the PharMetrics Plus TM US administrative claims database with at least one prescription for, or administration of, fingolimod, glatiramer acetate (GA), interferon (IFN), or natalizumab (index DMT) between October 1, 2010 and September 30, 2011 were included. Patients were naïve to index DMT (no claim in the previous 360 days) and had an MS diagnosis code within 360 days of the first index DMT prescription. Outcomes were persistence, risk of discontinuing index DMT (evaluated by a Cox proportional hazards model), adherence (measured using the medication possession ratio [MPR] and proportion of days covered [PDC] in patients with at least two index DMT prescriptions), and the risk of being non-adherent (MPR580% and PDC 580%, assessed using a logistic regression model). Results:The study included 3750 patients (fingolimod, n ¼ 889; GA, n ¼ 1233; any IFN, n ¼ 1341; natalizumab, n ¼ 287). Discontinuation rates (fingolimod, 27.9%; GA, 39.5%; IFN, 43.7%; natalizumab, 39.5%; all p50.001) and risk of discontinuation were significantly higher (hazard ratios vs fingolimod [95% confidence interval]: GA, 1.75 [1.49-2.07]; IFN, 2.01 [1.71-2.37]; natalizumab, 1.53 [1.22-1.91]) for patients receiving other DMTs compared with fingolimod. The risk of being non-adherent was also lower for patients in the fingolimod cohort than the other treatment cohorts, irrespective of whether nonadherence was defined as MPR580% (p50.05 for all) or PDC580% (p50.05 for GA and IFN). Limitations:As with all studies assessing real-world treatment patterns it is unclear if medications were used as prescribed. Conclusions:In a real-world setting, persistence with, and adherence to, oral fingolimod was higher than for injectable and infusible DMTs.

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Section: Introductionmentioning

confidence: 99%

“…Achieving therapeutic goals requires prompt treatment initiation and stringent adherence to both the medication dose and administration schedule [17][18][19][20] . Adherence is a measure of the extent to which patients take medication in accordance with the prescribed regimen 21 .…”

Section: Introductionmentioning

confidence: 99%

Persistence with and adherence to fingolimod compared with other disease-modifying therapies for the treatment of multiple sclerosis: a retrospective US claims database analysis

Bergvall

Petrilla

Karkare

et al. 2014

Journal of Medical Economics

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“…La bassa frequenza di somministrazione potrebbe tradursi in un miglioramento dell'aderenza al trattamento con conseguenti benefici clinici per il paziente ed economici per il Servizio Sanitario Nazionale italiano. Nello studio di Ivanova i pazienti aderenti al trattamento con farmaci disease modifying presentano una riduzione delle ricadute gravi di circa il 7,5% (12,4% vs 19,9%; p = 0,013) e una riduzione dei costi totali medi (indiretti e diretti escludendo il costo del farmaco) di circa $ 2.544 ($ 14.095 vs $ 16.638; p = 0,048) in 2 anni di osservazione [44]. Nella presente valutazione economica è stata considerata un'aderenza al trattamento pari all'85% [24] per tutti i farmaci inclusi nell'analisi.…”

Section: Analisi DI Sensibilitàunclassified

[Budget impact analysis for peginterferon beta-1a in relapsing remitting multiple sclerosis in Italy]

Iannazzo¹,

Santoni

Saleri

et al. 2016

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BACKGROUND: Peginterferon beta-1a, injected every two weeks, is the first approved pegylated interferon beta-1a for the treatment of relapsing remitting multiple sclerosis (RRMS). The objective of this analysis was to estimate the economic impact due to the introduction of peginterferon beta-1a in Italy.METHODS: This analysis was conducted with a three-year time horizon with the support of a simple decision-analytic model adopting the perspective of the Italian National Healthcare Service (NHS). Healthcare costs sustained by the Italian NHS to manage the RRMS population (drug treatment, monitoring, relapse management, adverse events management) were calculated over 3 years and compared in two scenarios: the base scenario where interferons-beta and glatiramer acetate (GA) are used to treat RRMS patients, and an alternative scenario where peginterferon beta-1a can also be used to treat RRMS patients. The target population was approximately 35,500, 37,500 and 39,500 patients at year 1, 2 and 3 respectively, based on the published literature and market data. The efficacy of treatments was simulated as a reduction of relapse rates and was derived from a Network Meta-analysis. Unit costs were based on current prices and tariffs, and the published literature. A one-way sensitivity analysis was developed.RESULTS: According to current price and described assumptions, it was estimated that the introduction of peginterferon beta-1a would result in a decrease of total costs when compared with the base scenario. The cost in the base scenario was estimated to be € 321.5, € 339.7 and € 357.8 million in years 1, 2, and 3, respectively. In the alternative scenario, the same costs resulted in about € 321.1, € 338.6 and € 356.2 million, respectively. The cumulative budget impact over three years period was approximately a cost saving of € 3.1 million (about 0.3% saving).CONCLUSION: The adoption of peginterferon beta-1a for the treatment of RRMS would be viewed as economically sustainable by the Italian NHS.[Article in Italian]

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“…[1][2][3][4] An observational, multicenter, multinational phase 4 study of over 2,000 patients with an average treatment duration of 31 months found that the most common reason for medication nonadherence was forgetting to take the injection (50.2%). 3 Twenty-five percent of the patients in this analysis were nonadherent (i.e., missed at least 1 dose).…”

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confidence: 99%

“…3 In an analysis of 648 patients from an employer-based database, over a 2-year period, patients that were adherent to their DMDs had a 12.4% rate of severe relapse (i.e., hospitalization or ER visit) versus 19.9% for the nonadherent patients (P = 0.013). 4 Another 12-month analysis of an administrative claims database that used 2,446 subjects…”

mentioning

confidence: 99%

Use of an Early Disease-Modifying Drug Adherence Measure to Predict Future Adherence in Patients with Multiple Sclerosis

Kozma¹,

Phillips²,

Meletiche³

2014

JMCP

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BACKGROUND: Patients with multiple sclerosis (MS) who are adherent to their treatment regimens are less likely to experience relapses and the cost associated with relapse. Pharmacists whose practice involves these specialty pharmaceuticals used to treat MS are striving for ways to improve outcomes by achieving treatment adherence in their patients. Specialty pharmacies have reported higher adherence rates than traditional pharmacies, which may translate to improved outcomes. Identifying patients who warrant increased adherence intervention is critical. Models using administrative health care claims to predict adherence have typically included demographic characteristics, comorbidities, and/or previous consumption of health care resources. Addition of a measure of early adherence may improve the ability to predict future adherence outcomes.

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Impact of medication adherence to disease-modifying drugs on severe relapse, and direct and indirect costs among employees with multiple sclerosis in the US

Cited by 102 publications

References 33 publications

Persistence with and adherence to fingolimod compared with other disease-modifying therapies for the treatment of multiple sclerosis: a retrospective US claims database analysis

Persistence with and adherence to fingolimod compared with other disease-modifying therapies for the treatment of multiple sclerosis: a retrospective US claims database analysis

[Budget impact analysis for peginterferon beta-1a in relapsing remitting multiple sclerosis in Italy]

Use of an Early Disease-Modifying Drug Adherence Measure to Predict Future Adherence in Patients with Multiple Sclerosis

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