Real-World Clinical and Economic Outcomes Among Persons With Multiple Sclerosis Initiating First- Versus Second- or...

Area of Science:

• Neurology
• Pharmacoeconomics
• Real-world evidence

Background:

• High-efficacy disease-modifying therapies (DMTs), including ocrelizumab (OCR), can reduce relapses and delay progression in multiple sclerosis (MS).
• Limited research exists on the real-world clinical and economic impact of early versus later initiation of OCR in persons with MS (pwMS).

Purpose of the Study:

• To evaluate differences in events often associated with a relapse (EOAR) and non-DMT healthcare resource utilization (HCRU) and costs.
• To compare outcomes for pwMS initiating OCR as first-line treatment versus second- or later-line treatment.

Main Methods:

• Adult pwMS initiating OCR post-diagnosis were identified from claims data (2015-2021).
• A 1:1 matched cohort design was used, comparing first-line OCR (1L OCR) with second- or later-line OCR (2L+ OCR) using stabilized inverse probability of treatment weighting.
• Annualized EOAR, non-DMT HCRU, and costs were assessed during the follow-up period.

Main Results:

• The 1L OCR cohort (n=748) showed a significantly lower annualized rate of EOAR compared to the 2L+ OCR cohort (0.37 vs. 0.56).
• PwMS in the 1L OCR cohort experienced a lower probability of hospitalization, fewer outpatient visits, and reduced all-cause and MS-related non-DMT costs.
• These differences were statistically significant.

Conclusions:

• First-line initiation of OCR in pwMS is associated with improved clinical outcomes, specifically fewer EOAR.
• Early OCR use also led to significant reductions in non-DMT healthcare costs and resource utilization.
• Initiating OCR as a first-line therapy may offer benefits to both patients and the healthcare system.