Insights Into Early Stages of Alzheimer's Disease Using Claims Data

Abstract

Objectives: Non-compliance in drug therapy is considered a significant source of waste in health care systems. For treatment of multiple sclerosis, a new generation of high-cost disease modifying therapies (DMT) have come to market in the last decade. Besides offering new active ingredients and thus increased treatment options, the mode of administration of these DMT has altered from injection to oral administration. In this study, we analyze the impact of innovation in DMT on medication persistence and adherence in multiple sclerosis patients in Germany. MethOds: We used data from data from over 2 million patients. We assessed the likelihood to adhere to (medicines possession ratio > 0.8) and discontinue (a gap occurs in medication supply in the range of one-fold duration of the previous prescription) by the type of drug used (innovation vs. standard therapy). We estimated a Bayesian logistic regression model, assuming a Bernoulli distribution as prior for the likelihood to discontinue/adhere and normal distribution as prior of the parameter estimates. We controlled for dosage frequency, treatment complexity and socioeconomic status (age, gender, income, insurance status). We accounted for switching behavior from standard to innovation. Results: 582 MS patients filled at least two prescriptions between 2012 and 2015. 184 used the innovation. 120 switched from standard to innovation. The likelihood to discontinue significantly decreased for the patients using the innovation only compared to standard therapy (mean odds ratio (OR):0.182). Simultaneously, their likelihood to adhere significantly increased (OR:2.93). Patients switching to innovation showed a significantly higher likelihood to discontinue (OR:2.43) whereas the likelihood to adhere did not differ from standard therapy. cOnclusiOns: New DMTs seem to ease patients' ability to comply with drug therapy. However, there is a cost of altering treatments as patients switching therapies seem more vulnerable in maintaining persistence. Active management of their drug therapy could be of benefit. PND70 iNsiGHts iNto early staGes of alzHeimer's Disease usiNG claims Data Ansorge S, Hapfelmeier J, Ertl J arvato health analytics, Munich, GermanyObjectives: Alzheimer's disease (AD) is the cause of around 50% to 70% of all cases of dementia. There is no definitive evidence that curing or preventing AD is possible. However, symptoms can be treated by supplying targeted medication. AD is often recognized late, when the disease burden on the patient is already high. Detecting and treating the disease and its early symptoms can have a large impact on the quality of life at old age. Therefore, this work aims to detect common events in early stages of the disease to support early diagnosis. MethOds: Using health care claims data we selected patients newly diagnosed with AD, i.e. at least two years prior without ICD-10 code F00 (Dementia in AD) and G30 (AD). The patients were aligned at the index event of the first diagnosis. This allowed for a longitudinal analysis spanning ...