A Descriptive Analysis of Time to First Treatment with Disease-Modifying Drugs in Newly Diagnosed Patients with Multiple Sclerosis

Background: Evidence suggests that early treatment with disease-modifying drugs (DMDs) following a diagnosis of relapsing multiple sclerosis (MS) is recommended for most patients with MS.

Objectives: To examine the time to first DMD prescription in newly diagnosed patients with MS.

Methods: This retrospective database analysis of newly diagnosed patients with MS was conducted using a national managed care database. Patients aged 18–64 years, with a first MS claim (ICD-9-CM: 340.xx) between 1/1/2008 and 12/31/2011 (index date), with continuous eligibility for 6 months pre- and 24 months post-index, and who had at least one DMD claim during the 24-month post-index period were included in the analysis. Patients who had evidence of DMD use prior to their first MS claim were excluded. Categorical and binary variables were summarized using frequencies and percentages. Continuous variables were summarized using means, standard deviations (SDs), and medians.

Results: A total of 7993 patients with MS met study inclusion criteria. Mean age was 42.7 years (SD=10.2) and 75.5% were female. Patients were most likely to be from the Midwest (32.6%) or Northeast (30.3%) regions, which reflects sampling for the national database used in this study. The average time from first MS diagnosis to first DMD claim was 150 days (SD=181), with a median time of 64 days. Examining the time to first DMD treatment showed that 28.2% received their first DMD in less than 30 days, 48.1% in less than 60 days, 58.7% in less than 90 days, and 71.6% in less than 180 days. Over one-quarter of patients (28.4%) did not have their first DMD claim for 180 or more days following their first MS diagnosis. A secondary analysis examined time to first DMD claim for newly treated patients with any available data in the post-index period (n=9359). The mean and median time to DMD treatment for this broader population was 295.5 (SD=408.4) and 89 days, respectively.

Conclusions: This study demonstrates that many patients with newly diagnosed MS have a delay before having their first DMD claim, with 28.4% waiting to start therapy for at least 6 months. Data suggest that early initiation of DMD therapy following a diagnosis of relapsing MS is important for optimizing MS management.