Price Increases and New Drugs Drive Increased Expenditures for Multiple Sclerosis

Schafer, Jeremy A.; Gunderson, Brent W.; Gleason, Patrick P.

doi:10.18553/jmcp.2010.16.9.713

Cited by 18 publications

(12 citation statements)

References 12 publications

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“…The increase in DMD charges from 2006 to 2011 in the sample overall may be attributable to an increased number of available DMDs, as well as price inflation among existing DMDs [28]. A surprising finding of the present study is that the proportion of continuously enrolled patients with at least 1 DMD claim remained constant at about 53%-54% from 2006 to 2011.…”

Section: Discussionmentioning

confidence: 62%

Updated cost-of-care estimates for commercially insured patients with multiple sclerosis: retrospective observational analysis of medical and pharmacy claims data

Carroll

Fairman

Lage

2014

BMC Health Serv Res

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BackgroundFor patients with multiple sclerosis (MS), previous research identified key disease sequelae as important cost drivers and suggested that among users of disease-modifying drugs (DMDs) in 2004, DMDs represented 73% of the total cost of care. More recent studies were limited to incident disease/treatment and/or excluded DMDs from cost estimates. To support contemporary pharmacoeconomic analyses, the present study was conducted to provide updated information about MS-related costs and cost drivers including DMDs.MethodsFor each of 2 years, 2006 and 2011, commercially insured, continuously eligible patients with ≥ 1 medical claim diagnosis of MS were sampled. MS-related charges were based on medical claims with MS diagnosis plus medical/pharmacy claims for DMDs. 2006 charges were adjusted to 2011 $ using the medical care component of the consumer price index (CPI). Subgroups of patients using DMDs (interferon [IFN] beta-1a intramuscular or subcutaneous, IFN beta-1b, glatiramer, natalizumab) in 2011 were identified. By-group differences were tested with bivariate statistics.ResultsMean (standard deviation [SD]) age of 15,902 sample patients in 2011 was 47.6 (11.8) years, 76% female. Mean [SD] MS charges ($26,520 [$38,478] overall) were significantly (P < 0.001) higher for patients with common disease sequelae: malaise/fatigue (n = 2,235; $39,948 [$48,435]), paresthesia (n = 1,566; $33,648 [$45,273]), depression (n = 1,255; $42,831 [$51,693]), and abnormality of gait (n = 1,196; $48,361 [$55,472]). From 2006 to 2011, CPI-adjusted MS charges increased by 60%. Among patients treated with a single DMD in 2011, inpatient care was 6% of charges (range = 4%-8%; P = 0.155); outpatient care was 19% (range = 14%-20% except for natalizumab [29%]; P < 0.001); and DMDs were 75% (range = 67%-81%; P < 0.001).ConclusionsCommon MS sequelae remain important cost drivers. Although MS treatment costs are increasing, the proportion of MS charges due to DMDs in 2011 is similar to that reported in 2004.

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Section: Discussionmentioning

confidence: 62%

Updated cost-of-care estimates for commercially insured patients with multiple sclerosis: retrospective observational analysis of medical and pharmacy claims data

Carroll

Fairman

Lage

2014

BMC Health Serv Res

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“…Dalfampridine, a potassium channel blocker, was approved by the FDA in order to improve walking in patients with MS (44). However, dalfampridine is included in the scope of OLDU, because it is unlicensed in Turkey, as seen in this study.…”

Section: Discussionmentioning

confidence: 99%

A nationwide evaluation of off-label drug utilization in Turkey

Özdamar¹,

Akıcı²,

Alkan³

et al. 2017

Turk J Med Sci

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Background/aim: Off-label drug use (OLDU) is under the control of the Turkish Medicines and Medical Devices Agency (TMMDA) in Turkey. It was aimed to investigate demographic and medical features of patients with OLDU applications in Turkey. Materials and methods:A total of 4426 electronic OLDU application records of the TMMDA were evaluated retrospectively. Information regarding patients' demographic characteristics, diagnoses, requested drugs, institutions, and specialties of the physicians were evaluated.Results: OLDU applications were mostly made by rheumatologists (21.5%) and 95.2% of them were approved by the TMMDA. The mean age of the patients was 35 years and 54.4% of them were female. Off-label drugs were mostly prescribed for patients aged 18-64 years (62.1%) and were most frequently prescribed by physicians from university medical centers (81.0%). Systemic lupus erythematosus (10.1%) was the most common diagnosis. Mycophenolate (16.1%) and rituximab (10.1%) were the most frequently prescribed off-label drugs. There were differences regarding some characteristics of patients and their physicians among most frequently prescribed off-label drugs (P < 0.05). Conclusion:It is noteworthy that OLDU applications showed demographical and institutional differences. It is expected that this study will provide important contributions to physicians working in the relevant area with respect to treatment alternatives of diseases with treatment challenges.

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“…For instance, the annual cost of interferon beta-1a IM in the UK is about £8,000 (US$12,000) compared with ~US$25,000 (US$34,000 in 2010 values) in the USA 66 . Drug acquisition costs are also on the rise, with a compounded annual growth rate of 8.2 % in the USA between 2006 and 2009 67 . Noyes et al 47 recently demonstrated that if current DMT costs in the USA were reduced by two-thirds (which would match the prices in other industrialized countries), the cost effectiveness of DMTs would become comparable with the cost effectiveness of other accepted interventions 20 .…”

Section: Discussionmentioning

confidence: 99%

Modelling the Cost Effectiveness of Disease-Modifying Treatments for Multiple Sclerosis

2013

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Several cost-effectiveness models of disease-modifying treatments (DMTs) for multiple sclerosis (MS) have been developed for different populations and different countries. Vast differences in the approaches and discrepancies in the results give rise to heated discussions and limit the use of these models. Our main objective is to discuss the methodological challenges in modelling the cost effectiveness of treatments for MS. We conducted a review of published models to describe the approaches taken to date, to identify the key parameters that influence the cost effectiveness of DMTs, and to point out major areas of weakness and uncertainty. Thirty-six published models and analyses were identified. The greatest source of uncertainty is the absence of head-to-head randomized clinical trials. Modellers have used various techniques to compensate, including utilizing extension trials. The use of large observational cohorts in recent studies aids in identifying population-based, ‘real-world’ treatment effects. Major drivers of results include the time horizon modelled and DMT acquisition costs. Model endpoints must target either policy makers (using cost-utility analysis) or clinicians (conducting cost-effectiveness analyses). Lastly, the cost effectiveness of DMTs outside North America and Europe is currently unknown, with the lack of country-specific data as the major limiting factor. We suggest that limited data should not preclude analyses, as models may be built and updated in the future as data become available. Disclosure of modelling methods and assumptions could improve the transferability and applicability of models designed to reflect different healthcare systems.

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Price Increases and New Drugs Drive Increased Expenditures for Multiple Sclerosis

Cited by 18 publications

References 12 publications

Updated cost-of-care estimates for commercially insured patients with multiple sclerosis: retrospective observational analysis of medical and pharmacy claims data

Updated cost-of-care estimates for commercially insured patients with multiple sclerosis: retrospective observational analysis of medical and pharmacy claims data

A nationwide evaluation of off-label drug utilization in Turkey

Modelling the Cost Effectiveness of Disease-Modifying Treatments for Multiple Sclerosis

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