Real-World Adherence and Persistence to Oral Disease-Modifying Therapies in Multiple Sclerosis Patients Over 1 Year

• DOI: 10.18553/jmcp.2017.23.8.844
• Publication Date: 2017-07-24T17:47:32Z
• Authors: Kristen M. Johnson; Huanxue Zhou; Feng Lin; John J. Ko; Vivian Herrera
• Keywords: Teriflunomide; Discontinuation

Disease-modifying therapies (DMTs) are indicated to reduce relapse rates and slow disease progression for relapsing-remitting multiple sclerosis (MS) patients when taken as prescribed. Nonadherence or non-persistence in the real-world setting can lead greater risk negative clinical outcomes. Although previous research has demonstrated adherence persistence oral DMTs compared with injectable DMTs, comparisons among lacking.To compare adherence, persistence, time discontinuation MS newly prescribed fingolimod, dimethyl fumarate, teriflunomide.This retrospective study used MarketScan Commercial Medicare Supplemental claims databases. ≥ 1 claim specified from April 1, 2013, June 30, were identified. The index drug was defined first DMT within this period. To capture initiating could not have a their drugs 12 months. Baseline characteristics described each treatment cohort. Adherence, measured by medication possession ratio (MPR) proportion of days covered (PDC); (30-day gap allowed); over 12-month follow-up period across cohorts. Adjusted logistic regression models examine Cox estimated discontinuation.1,498 initiated met inclusion criteria: fingolimod (n = 185), fumarate 1,160), teriflunomide 143). Patients similar most baseline characteristics, including region, history, health care resource utilization. Statistically significant differences observed cohorts age, gender, injectable/infused use, comorbidities. Adherence adjusted Charlson Comorbidity Index score. Relative patients, significantly less likely an MPR 80% (OR 0.18; 95% CI 0.09-0.36; P < 0.001 OR 0.19; 0.08-0.42; 0.001, respectively). Similarly, relative PDC 0.47; 0.33-0.67; 0.37; 0.23-0.59; Additionally, HR about 2 times (HR 1.93; 1.44-2.59; 0.001) 2.27; 1.57-3.28; fingolimod.In setting, taking had better other Coupled factors, should be important considerations determining coverage decisions patients.This funded Novartis Pharmaceuticals. Johnson, Lin, Ko, Herrera employed Pharmaceuticals own stock. Huanxue Zhou is KMK Consulting, which provides consulting services Novartis. Study concept design contributed Herrera. collected data, data interpretation performed All authors involved manuscript revision. abstract presented at AMCP Nexus 2015; October 26-29, Orlando, Florida.