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ABSTRACT
Objective: The purpose of this analysis was to assess the differences in lost time and health-benefit costs (HBCs) among employees treated with disease modifying treatments (DMTs) for multiple sclerosis (MS).
Study design: Employees with an MS diagnostic code (ICD-9 340.xx) and a DMT prescription claim (1/1/2001–6/30/2007) were identified from the HCMS Research Reference Database and assigned to DMT cohorts. The first prescription for the DMT was used as each person's index date. One-year outcomes included HBCs and absenteeism (lost time, comprising sick leave [SL], short- and long-term disability [STD/LTD], and workers’ compensation).
Methods: Demographics were compared using t-tests for continuous variables and chi-square tests for discrete variables. Two-part multivariate regression modeling (logistic regression combined with generalized linear regression) was used to determine annual HBCs and absenteeism for each cohort controlling for age, gender, job-related variables, and Charlson Comorbidity Score. All cost variables were inflated to US$2007.
Results: Annual ranges among the DMTs were: HBCs $17 953–26 970 and absenteeism 7.33–20.67 days. Compared with glatiramer acetate (‘C’), IFN-β1a IM (‘A’) users had lower SL ($445, p = 0.0469) and STD ($969, p = 0.0164) costs; and IFN-β1b (‘B’) users had lower medical costs ($2143, p = 0.0091). In addition, those treated with ‘A’ had 4.2 fewer SL days (p = 0.0101) compared with those treated with ‘C’.
Conclusions: Patients treated with ‘A’ reported significantly lower SL costs, SL days, and STD costs than patients treated with ‘C’, suggestive of greater real world benefits with ‘A’. Despite small sample sizes and the retrospective nature, the study provides interesting insights into the use of DMTs in MS. The study also revealed important areas of future research, specifically the need for development of methods to determine which MS patient groups respond best to which DMT treatments.
Transparency
Declaration of funding
This article was funded by Biogen Idec, Inc, Cambridge, MA, USA. Financial support for this study was provided to R.A.B., N.L.K. and A.K.M. by Biogen Idec.
Declaration of financial/other relationships
R.A.B. and N.L.K. have disclosed that they have received travel support for meetings and presentations from Biogen Idec. K.R. has disclosed she is employed by Biogen Idec and provided input on the protocol design and inclusion and exclusion criteria, and assisted with the interpretation and reporting of results.
All peer reviewers received honoraria for peer reviewing for CMRO. Peer Reviewer 1 has disclosed that he/she has received research grants from Genzyme and Genentech, and has served as a consultant to Novartis. Peer Reviewer 2 has disclosed that he/she has no relevant financial relationships.
Acknowledgment
For assistance with reviews of the data and drafts of this manuscript, the authors thank James E. Smeeding, RPh, MBA, President of the JeSTARx Group, and Harold H. Gardner, MD, President of HCMS.
Notes
* Some data in this manuscript were published in abstract form in conjunction with poster presentations at the Academy of Managed Care Pharmacy's 20th Annual Meeting & Showcase, San Francisco, CA, USA, April 16–19, 2008; the International Society of Pharmaceutical Outcomes Research's 13th Annual International Meeting, Toronto, ON, Canada, May 3--7, 2008; and the Consortium of Multiple Sclerosis Center's 22nd Annual Meeting, Denver, CO, USA, May 28--30, 2008
* Avonex is a registered trade name of Biogen Idec Pharmaceuticals, Cambridge, MA, USA
† Betaseron is a registered trademark of Bayer HealthCare Pharmaceuticals Inc., West Haven, CT, USA
‡ Rebif is a registered trademark of EMD Serono, Inc. Rockland, MA and its affiliates.
§ Copaxone is a registered trademark of Teva Pharmaceutical Industries Ltd., Petach Tikva, Israel