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Published on: December 9, 2015
Factors associated with delays in multiple sclerosis disease-modifying therapy initiation
Laura Snider, Elsa Rodriguez, Hannah Rains
1Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, USA.
Summary
Delays in starting multiple sclerosis (MS) disease-modifying therapy (DMT) are linked to longer distances from clinics and using outside pharmacies. These factors significantly impact treatment initiation times for people with MS.
Area of Science:
- Neurology
- Clinical Pharmacy
- Health Services Research
Background:
- Delayed initiation of disease-modifying therapy (DMT) in multiple sclerosis (MS) is linked to poorer clinical outcomes.
- Understanding factors influencing DMT start-up times is crucial for optimizing patient care.
Purpose of the Study:
- To investigate associations between patient and logistical factors and the time taken to initiate DMT in people with MS (PwMS).
Main Methods:
- A single-center retrospective chart review of 116 treatment-naive and previously treated PwMS initiated on DMT between September 2021 and September 2023.
- A generalized linear model assessed correlations between DMT start-up times and geographic distance, clinic/pharmacy utilization, insurance, education, administration route, race/ethnicity, and income.
Main Results:
- Increased distance to the MS center (>100 km) correlated with longer start-up times (76.5 vs. 53.5 days, p=0.04).
- PwMS with private insurance experienced longer start-up times compared to those with other insurance types (66 vs. 50.5 days, p=0.016).
- Utilizing external infusion centers and specialty pharmacies significantly delayed DMT initiation (82.5 vs. 39.5 days, p=0.024).
Conclusions:
- Longer DMT start-up times in MS are associated with greater geographic distance, private insurance, and reliance on external infusion centers and specialty pharmacies.
- These findings highlight potential barriers to timely MS treatment initiation that warrant further investigation and intervention.
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