One-Year Outcomes of an Integrated Multiple Sclerosis Disease Management Program

Area of Science:

• Pharmacoeconomics
• Health Services Research
• Chronic Disease Management

Background:

• Multiple sclerosis (MS) incurs high healthcare costs, primarily driven by medication expenses.
• Patient adherence to disease-modifying treatments is crucial for reducing relapses, emergency department visits, and hospitalizations.
• Disease management programs aim to enhance medication adherence and improve clinical and economic outcomes.

Purpose of the Study:

• To assess the clinical and economic impact of a specialty pharmacy and chronic disease management program for MS patients.
• Evaluation was conducted from a health plan's perspective.

Main Methods:

• Retrospective analysis of prescription drug claims, medical claims, and electronic medical records (2013-2015).
• Included patients with 24 months of continuous health plan coverage, analyzing data one year before and after program enrollment.
• Medication adherence measured by proportion of days covered (PDC); relapse rate defined by specific clinical events; disease progression by mEDSS; resource use by visits and hospitalizations; costs as health plan-paid amounts.

Main Results:

• Improved medication adherence, with 78.7% of patients achieving a PDC ≥ 0.80 post-enrollment compared to 70.0% prior (P < 0.001).
• No significant changes observed in MS relapse rates (0.25 vs. 0.45, P = 0.11) or mEDSS scores (3.77 vs. 3.76, P = 0.19).
• Healthcare resource utilization (outpatient visits, ED visits, hospitalizations) remained stable; average annual health plan spend on MS medications significantly increased ($55,835 vs. $40,883, P < 0.001).

Conclusions:

• Specialty pharmacy and chronic disease management effectively increase medication adherence in MS patients.
• The observed increase in MS medication costs was not counterbalanced by reductions in healthcare resource utilization or associated savings.