QL10
The Impact of Relapse on Productivity, Costs, and Resource Utilization in Multiple Sclerosis: A Retrospective U.S. Database Analysis
Objectives: To assess the impact of relapse on productivity, health care resource utilization (HCRU), and costs in MS patients over a 4 year period in the United States.
Methods: A retrospective study of Truven Health MarketScan claims database and Health and Productivity Management database (HPM) during 2006-2012 was conducted. Adult MS patients (≥2 MS diagnoses ≤60 days, ICD-9-CM: 340.xx) with continuous medical and pharmacy benefits in the 1-year baseline period and 4-year follow-up period were included (no single gap in enrollment >40 days). A published claims-based algorithm was employed to categorize patients into 2 groups based on care-seeking behavior: no relapse or relapse. Descriptive statistics were generated on baseline demographics and clinical characteristics. Annual MS-related HCRU (number of hospitalizations, ER visits, and physician office visits), productivity (number of days absent), and associated costs ($) were estimated during the follow-up period.
Results: A total of 4,119 MS patients had medical and pharmacy claims, of whom 411 also had HPM data; 77% were female, 65% were employed full-time, and 67% were covered by PPO. In the relapse and no relapse groups, the mean number [SD] of annual MS-related claims for hospital admissions, ER visits, and physician office visits were: 1.5[1.8] & 0[0], 2.6[4.4] & 1.7[1.9], and 13.8[9.2] & 7.8[6.8], respectively. Mean annual MS-related costs were: $23,347[103,303] & $0[0], $2,714[30,817] & $714[1531], and $1,661[1,818] & $899[1,024], respectively. In terms of productivity, for the relapse and no relapse groups, the mean number of days absent from work per year was 18.9[25.6] & 13.6[13.8], respectively. Over the follow-up period, the mean number of days absent per year increased from 17 to 50 days (per 1000 patients) in the relapse group and decreased from 30 to 21 days (per 1000 patients) in the no relapse group.
Conclusions: Our study describes annual impacts on productivity, HCRU, and cost in MS patients with confirmed relapse versus those without. In this relatively healthy, commercially insured population, MS relapses are associated with increased economic and humanistic burden. This study may underestimate the full burden of MS by not capturing outcomes such as non-clinically confirmed relapses, which are not reflected in claims data.