Health Insurance Status Affects Medication Use in MS

Reimbursement
Reimbursement
Nearly 25% of respondents taking DMDs use free or discounted drug programs.

Rising costs and insurance coverage of disease-modifying drugs (DMDs) for multiple sclerosis adversely impact access to treatment, according to results from a large survey.

Notably, nearly 25% of respondents taking DMDs use free or discounted drug programs to pay for their treatment.

In order to evaluate the impact of health insurance coverage on DMD use, Guoqiao Wang, PhD, of the University of Alabama Birmingham, and colleagues surveyed participants of the North American Research Committee on MS registry in 2014. Ultimately, 6662 respondents were included in the analysis.

Over 98% of respondents reported having health insurance, however just over 22% reported having a negative insurance change compared to the year prior. Notably, respondents who had private insurance were more likely to report a negative change in insurance. Just over 6% of respondents who were not taking DMDs cited financial/insurance concerns as the sole reason. Among respondents who obtained DMDs through insurance, 3.3% experienced initial insurance denial of DMD use, 2.3% experienced denial of DMD switches, and 1.6% had to skip to split doses because of copay increase. Among respondents with relapsing-remitting multiple sclerosis, a negative insurance change increased the likelihood of not taking DMDs (odds ratio [OR] 1.50; 1.16–1.93), using free or discount drug programs to obtain DMDs (OR 1.89; 1.40–2.57), and encountering insurance challenges (OR 2.48; 1.64–3.76).

The researchers noted that economic analysis that does not account for the use of free or discount drug programs – which are substantial among patients with multiple sclerosis – may contribute to inaccurate results.

Reference

Wang G, Marrie RA, Salter AR, et al. Health insurance affects the use of disease-modifying therapy in multiple sclerosis. Neurology. 2016; doi: 10.1212/WNL.0000000000002887.