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Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla
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Multiple sclerosis disease-modifying therapy prescribing patterns in Ontario.

James J Marriott1, Muhammad Mamdani, Gustavo Saposnik

  • 1Department of Internal Medicine (Neurology), University of Manitoba, Winnipeg, Manitoba, Canada. jmarriott@hsc.mb.ca

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
|December 20, 2012
PubMed
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A small group of neurologists prescribe most multiple sclerosis (MS) disease-modifying therapies (DMTs). MS specialists who prescribe more DMTs use a wider variety of treatments compared to those who prescribe less.

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Area of Science:

  • Neurology
  • Pharmacology
  • Health Services Research

Background:

  • Prescribing patterns for multiple sclerosis (MS) disease-modifying therapies (DMTs) vary among neurologists.
  • Differences between MS specialists and general neurologists in DMT prescribing remain unexplored.

Purpose of the Study:

  • To analyze the concentration of DMT prescribing patterns.
  • To determine if MS specialists utilize a broader spectrum of DMTs than general neurologists.

Main Methods:

  • Cross-sectional study utilizing administrative claims data from Ontario, Canada.
  • MS specialization defined by practice location and prescription data.
  • Lorenz curves and Gini coefficients analyzed DMT prescribing patterns, differentiating between high- and low-volume prescribers and specific DMTs.

Main Results:

  • Prescription data showed high concentration, with 12% of neurologists issuing 80% of DMTs.
  • A trend indicated more frequent prescription of Avonex compared to other DMTs.
  • High-volume prescribers, identified as MS specialists, demonstrated broader DMT selection (Gini 0.38-0.44) versus low-volume prescribers (Gini 0.57-0.66).

Conclusions:

  • A small cohort of neurologists dominates DMT prescribing for MS.
  • High-volume MS specialists exhibit greater diversity in DMT utilization.
  • Low-volume prescribers tend to concentrate on a limited range of DMTs.