Association between multiple sclerosis disease severity and adherence to disease-modifying therapies

Area of Science:

• Neurology
• Pharmacoeconomics
• Health Services Research

Background:

• Treatment adherence is vital for multiple sclerosis (MS) patients on disease-modifying therapies (DMTs) to manage disease progression and symptoms.
• Understanding factors influencing DMT adherence is critical for optimizing patient outcomes.

Purpose of the Study:

• To evaluate the association between a claims-based measure of MS disease severity and DMT adherence over a one-year period.
• To identify demographic and clinical factors associated with DMT adherence in MS patients.

Main Methods:

• Retrospective analysis of Medicare Advantage claims data (2013-2015) for 3,347 MS patients.
• Calculated medication possession ratio (MPR) for DMT adherence (MPR ≥ 0.8) and used an algorithm to assess MS disease severity.
• Employed multivariable logistic regression to analyze the impact of MS disease severity, age, gender, and DMT type on adherence.

Main Results:

• Overall adherence rate was 75%, with an average MPR of 84.7.
• Increased age (46-64 and 65+ groups) was associated with higher DMT adherence compared to the 18-45 age group.
• Higher MS disease severity significantly decreased the likelihood of DMT adherence (OR: 0.47).

Conclusions:

• Older age and lower MS disease severity are linked to improved DMT adherence in multiple sclerosis patients.
• MS disease severity is a significant factor to consider when assessing the risk of poor DMT adherence.
• These findings can inform strategies to improve treatment adherence in MS care.