Characteristics and Utilization Of MS Patients In a Commercially Insured US Population

Background: Multiple Sclerosis (MS) is a debilitating disease that impacts the central nervous system (CNS). Although MS prevalence is relatively low, disease burden can be sizeable in terms of resource utilization, and vary depending on clinical characteristics at time of disease onset.  This research will assess demographic and some clinical characteristics associated with MS patients.

Objectives: To describe demographic, clinical characteristics, and resource use of MS patients.

Methods: A retrospective cohort study using the HealthCore Integrated Research Database (HIRD^SM) identified newly diagnosed MS patients (no MS diagnosis (ICD-9-CM 340.xx) or use of disease modifying therapies (DMTs) 12 months prior to “first” diagnosis). Individuals were > 18 years old and identified between 1/1/2006 and 4/30/2012. The study characterized patients based on demographics, clinical characteristics and use of DMTs and other MS-related medications. Demographic characteristics included age and gender. Clinical characteristics included pre-index Deyo-Charlson Comorbidity Index (DCI) and comorbidities. Use of DMTs and all-cause healthcare resource utilization were measured in the entire post-index period, while other MS-related medications were measured in the 12 month pre- and entire post-index periods.

Results: 4,567 MS patients were identified. Patients had a mean age of 47 years, and 74.1% were female. Some patients had presence of clinically isolated syndrome (16.0%) in the pre-index period.  The mean DCI score was 0.70, and the most prevalent pre-index comorbidities were high blood pressure (28.2%), depression (15.8%) and urinary tract infection (13.7%). Additionally, the most prevalent pre-index medications included antibiotics (53.3%), narcotics (35.1%) and corticosteroids (30.5%). During the post-index period, 40.8% of MS patients had ≥1 prescription for DMTs, while use of antibiotics, narcotics, and corticosteroids increased to 73.4%, 55.4%, and 59.6%, respectively. Overall, 39.7%, 42.7%, 99.7%, and 99.5% had all-cause inpatient, emergency room, office visits and other outpatient services, respectively in the post-index period.

Conclusions: Over half of MS patients were not treated with DMTs after diagnosis of MS, while use of other MS-related medications such as antibiotics, narcotics, and corticosteroids increased from pre-index to post-index periods.