Multiple sclerosis disease-modifying drug use by immigrants: a real-world study

Area of Science:

• Neurology
• Public Health
• Health Services Research

Background:

• Multiple sclerosis (MS) management includes disease-modifying drugs (DMDs).
• Little is known about DMD initiation patterns among immigrant populations with MS in universal healthcare systems.
• Understanding disparities in treatment access is crucial for equitable MS care.

Purpose of the Study:

• To assess the association between immigration status and DMD initiation within five years of the first MS-related healthcare encounter.
• To investigate if socioeconomic status modifies the relationship between immigration and DMD use.
• To identify potential barriers to timely MS treatment for immigrant populations.

Main Methods:

• Retrospective cohort study using health administrative data from British Columbia, Canada (1996-2012 index dates).
• Identified 8,762 individuals with MS (522 immigrants) meeting inclusion criteria (≥18 years, residency requirements).
• Logistic regression analysis evaluated the odds of filling any DMD prescription within five years post-index, adjusting for covariates.

Main Results:

• Overall, immigration status was associated with the odds of initiating a first DMD within five years of an MS-related encounter.
• Immigrants of lower socioeconomic status (SES) showed reduced odds of filling any DMD prescription.
• No significant difference in DMD use was observed between immigrants and long-term residents across higher SES quintiles.

Conclusions:

• Immigration status is a factor associated with disease-modifying drug initiation in multiple sclerosis.
• Lower socioeconomic status may exacerbate disparities in DMD access for immigrants with MS.
• Further research is needed to address inequities in treatment initiation for immigrant MS patients.