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

Müller, Sabrina; Heidler, Tobias; Fuchs, Andreas; Pfaff, Andreas; Ernst, Kathrin; Ladinek, Gunter; Wilke, Thomas

doi:10.1007/s40120-019-00172-5

Cited by 13 publications

(20 citation statements)

References 35 publications

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“…Moreover, the creation of clusters was based only on the care consumption of PwMS and not on clinical or demographic features, in contrast to previous studies. 2,[5][6][7][8] The overall care consumption of PwMS in our study was somewhat higher than in other studies that have also used longitudinal data.…”

Section: Discussioncontrasting

confidence: 78%

“…1–3 However, comprehensive, longitudinal data on care consumption in MS are lacking; 2,4,5 studies in this area have been cross-sectional. 6–8 Previous studies on differences in care consumption of persons with multiple sclerosis (PwMS) have compared groups defined, a priori, by initial MS course 7 or consultation with a neurologist, 2,8 or by comparison to the general population. 5,6 Thus, patterns of an individual’s care over time were not considered.…”

Section: Introductionmentioning

confidence: 99%

“…5,6 Thus, patterns of an individual’s care over time were not considered. Moreover, the physician specialty was either restricted to general practitioner (GP) and neurologist 7,8 or was not considered at all. 5,6 A recent study from our team accessed longitudinal administrative health data for PwMS in France, but MS-specific clinical data were not available and all health care providers (HCPs) were grouped together.…”

Section: Introductionmentioning

confidence: 99%

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Care consumption of people with multiple sclerosis: A multichannel sequence analysis in a population-based setting in British Columbia, Canada

et al. 2021

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Background: Persons with multiple sclerosis (PwMS) typically require complex multidisciplinary care, which is rarely formally assessed. Objectives: We applied multichannel sequence analysis (MCSA) to identify care consumption patterns by PwMS in British Columbia, Canada. Methods: We created two cohorts, comprising incident and prevalent MS cases, using linked clinical and administrative data. We applied MCSA to quantify and compare the care pathways of PwMS, based on all-cause hospitalizations and physician visits (divided into five specialities). Care consumption clusters were characterized using demographic and clinical features. Results: From 1048 incident and 3180 prevalent PwMS, the MCSA identified 12 and 6 distinct care consumption clusters over a median follow-up of 9.6 and 13.0 years, respectively. Large disparities between clusters were observed; the median number of annual consultations ranged from 5.6 to 21.3 for general practitioners, 1.2 to 4.6 for neurologists and 0 to 5.3 for psychiatrists in the incident cohort. Characteristics at MS symptom onset associated with the highest care consumption included high comorbidity burden and older age. There were similar disparities and associations for prevalent PwMS. Conclusion: The distinct patterns of care consumption, which were reminiscent of the heterogeneity of MS itself, may facilitate health service planning and evaluation, and provide a novel outcome measure in health research.

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Section: Discussioncontrasting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Care consumption of people with multiple sclerosis: A multichannel sequence analysis in a population-based setting in British Columbia, Canada

et al. 2021

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“…The average observation and treatment period of PANGAEA as well as its large sample size by far exceeds those of RCTs on fingolimod [2,4,5]. Both age and female gender of RRMS patients in PANGAEA corresponded to those found in a large German register study on 13,333 MS patients [19]. Patients who entered PANGAEA had similar mean ages and disease durations but more active disease at baseline when compared to patients participating in RCTs on fingolimod.…”

Section: Discussionmentioning

confidence: 74%

Long-term real-world effectiveness and safety of fingolimod over 5 years in Germany

Ziemssen

Lang²,

Schmidt

et al. 2022

J Neurol

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Objective To evaluate the 5-year real-world benefit–risk profile of fingolimod in patients with relapsing–remitting MS (RRMS) in Germany. Methods Post-Authorization Non-interventional German sAfety study of GilEnyA (PANGAEA) is a non-interventional real-world study to prospectively assess the effectiveness and safety of fingolimod in routine clinical practice in Germany. The follow-up period comprised 5 years. Patients were included if they had been diagnosed with RRMS and had been prescribed fingolimod as part of clinical routine. There were no exclusion criteria except the contraindications for fingolimod as defined in the European label. The effectiveness and safety analysis set comprised 4032 and 4067 RRMS patients, respectively. Results At the time of the 5-year follow-up of PANGAEA, 66.57% of patients still continued fingolimod therapy. Annualized relapse rates decreased from baseline 1.5 ± 1.15 to 0.42 ± 0.734 at year 1 and 0.21 ± 0.483 at year 5, and the disability status remained stable, as demonstrated by the Expanded Disability Status Scale mean change from baseline (0.1 ± 2.51), the decrease of the Multiple Sclerosis Severity Score from 5.1 ± 2.59 at baseline to 3.9 ± 2.31 at the 60-months follow-up, and the percentage of patients with ‘no change’ in the Clinical Global Impression scale at the 60-months follow-up (78.11%). Adverse events (AE) occurring in 75.04% of patients were in line with the known safety profile of fingolimod and were mostly non-serious AE (33.62%) and non-serious adverse drug reactions (50.59%; serious AE 4.98%; serious ADR 10.82%). Conclusions PANGAEA demonstrated the sustained beneficial effectiveness and safety of fingolimod in the long-term real-world treatment of patients with RRMS.

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“…Cost were therefore higher than those most recently reported for German RRMS patients within a healthcare claim data set (€20,583). 28 One factor contributing to this deviation is that we captured a wide-ranging societal perspective by using the MS-HRS survey. However, as no clinical data could be provided (e.g.…”

Section: Discussionmentioning

confidence: 99%

Gender disparities in health resource utilization in patients with relapsing–remitting multiple sclerosis: a prospective longitudinal real-world study with more than 2000 patients

Schriefer¹,

Ness²,

Haase³

et al. 2020

Ther Adv Neurol Disord

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Background: For the case of multiple sclerosis, research on gender differences from a health economics perspective has not received much attention. However, cost-of-illness analyses can provide valuable information about the diverse impact of the disease and thus help decision-makers to allocate scarce resources. The aim of this study was to describe healthcare resource use and associated societal costs from a gender perspective. In particular, we aimed to identify how resource utilization potentially differs in certain cost components between men and women. Methods: Clinical and economic data were extracted from two prospective, multicentre, non-interventional, observational studies in Germany. Information on health resource use was obtained from all patients on a quarterly basis using a validated questionnaire. Cost analyses were conducted from the societal perspective including all direct (healthcare-related) and indirect (work-related) costs, regardless of who bears them. Gender-related differences were analysed by a multivariable generalized linear model with a negative binomial distribution and log link function due to the right-skewed distribution pattern of cost data. In addition, costs for men and women were descriptively analysed within subgroups of two-year disease activity. Results: In total, 2095 patients (women-to-men ratio of 2.7:1) presented a mean age of 41.85 years and a median Expanded Disability Status Scale of 2 (interquartile range 1–3.5) ( p > 0.30 for gender-related differences). Women and men did not statistically differ in total quarterly costs (€2329 ± €2570 versus €2361 ± €2612). For both, costs were higher with advancing disease severity and indirect costs were the main societal cost driver. Regarding healthcare-related resources, women incurred higher costs for ambulant consultations [incidence rate ratio (IRR) 1.16, confidence interval (CI) 1.04–1.31], complementary medicine (IRR 2.41, CI 1.14–5.06), medical consumables (IRR 2.53, CI 1.69–3.79) and informal care (IRR 2.79, CI 1.56–5.01). Among indirect costs, we found higher costs for men for presenteeism (IRR 0.62; CI 0.53–0.72) and higher costs for women for disability pension (IRR 1.62; CI 1.23–2.13). Conclusions: Multiple sclerosis poses a significant economic burden on patients, families and society. While the total economic burden did not differ between male and female patients, we found gender differences in specific cost items that are similar to those in the wider non-MS population.

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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

Cited by 13 publications

References 35 publications

Care consumption of people with multiple sclerosis: A multichannel sequence analysis in a population-based setting in British Columbia, Canada

Care consumption of people with multiple sclerosis: A multichannel sequence analysis in a population-based setting in British Columbia, Canada

Long-term real-world effectiveness and safety of fingolimod over 5 years in Germany

Gender disparities in health resource utilization in patients with relapsing–remitting multiple sclerosis: a prospective longitudinal real-world study with more than 2000 patients

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