The following article is part of conference coverage from the 2019 Annual Meeting of the Consortium of Multiple Sclerosis Centers , in Seattle, Washington. Neurology Advisor‘s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from CMSC 2019.
SEATTLE — Nonadherence to once- or twice-daily oral disease-modifying drugs (DMDs) among individuals with multiple sclerosis (MS) is associated with considerable resource use and economic and clinical burden, according to research presented at the 33rd Annual Meeting of the Consortium of Multiple Sclerosis Centers, held May 28 through June 1, 2019, in Seattle, Washington.
This systematic literature review and meta-analysis included 3786 patients with MS from 5 studies on the economic and clinical burden related to nonadherence to once- or twice-daily oral DMD. Based on the findings, a 1-year health economic cost-consequence analysis model was constructed to predict the burden among 1000 individuals. Among the study outcomes were relapses, emergency department visits, lost days of work, direct and indirect costs, outpatient visits, and hospitalizations. Instead of point estimates, ranges of the impact of nonadherence were used to present different possible scenarios.
The 1-year proportion of days covered in 4 studies was 76.5% (95% CI, 72.0-81.1). Defining nonadherence as a proportion of days covered below 0.8, the meta-analysis showed a pooled adherence rate of 71.8% (95% CI, 59.1-81.9), with confidence intervals representing a plausible value range. In the 1000-participant cost-consequence analysis model, 16 to 36 MS relapses, 10 to 36 hospitalizations, 13 to 70 emergency department visits, 127 to 286 outpatient visits, 2835 to 4200 lost work days, $807,030 to $2,378,744 in direct costs, and $302,400 to $448,000 in indirect costs were caused by nonadherence in a single year.
The study researchers conclude that “the clinical and economic burden of nonadherence among patients with MS taking once- or twice-daily oral DMDs can be considerable. Treatment options with improved adherence may result in reduced resource use and related costs.”
The study authors report consulting fees and associations with pharmaceutical companies.
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Nicholas J, Edwards NC, Dellarole A, Harlow DE, Phillips AL. Clinical and economic burden of nonadherence to oral disease-modifying drugs in patients with multiple sclerosis: a cost-consequence model. Poster presented at: 33rd Annual Meeting of the Consortium of Multiple Sclerosis Centers; May 28-June 1, 2019; Seattle, WA. Abstract DXT38.