The relationship between alternative medication possession ratio thresholds and outcomes: evidence from the use of glatiramer acetate

Figures & data

Figure 1.  Inclusion/exclusion criteria.

Table 1.  Patient characteristics (n = 839).

Variable	n or Mean	% or SD
Age (mean; std dev)	45.17	10.38
Sex
Female	682	81.29
Male	157	18.71
Region
Northeast	100	11.92
Midwest	209	24.91
South	383	45.65
West	147	17.52
Insurance Type
Exclusive Provider Org	114	13.59
Health Maintenance Org	102	12.16
Independent	10	1.19
Point of Service	560	66.75
Preferred Provider Org	53	6.32
Copay (mean; std dev)	$55.31	$78.27
MPR Threshold
0.10	782	93.21
0.25	682	81.17
0.50	498	59.36
0.70	426	50.77
0.80	372	44.34
0.90	307	36.54
0.95	241	28.72

Figure 2.  Odds ratio—relapse. Odds ratio (square box) with 95% confidence intervals.

Figure 3.  Charge offsets associated with alternative MPR thresholds.

Table 2.  Association between alternative MPR threshold and total charge components.*

MPR threshold	Inpatient		Outpatient		Emergency room		Prescription drug
	Incremental effect	p-value	Incremental effect	p-value	Incremental effect	p-value	Incremental effect	p-value
0.10	−$3,880.03	0.066	−$1,382.47	0.062	−$113.10	0.010	−$261.35	0.467
0.25	−$1,064.53	0.435	−$1,231.47	0.009	−$69.25	0.120	−$331.19	0.148
0.50	−$3,370.27	0.002	−$1,077.12	0.004	−$95.95	0.006	−$205.77	0.260
0.70	−$5,197.76	<0.001	−$1,140.87	0.002	−$95.04	0.006	−$236.57	0.188
0.80	−$6,047.36	<0.001	−$1,103.96	0.003	−$80.35	0.022	−$211.03	0.245
0.90	−$6,936.35	<0.001	−$1,060.34	0.006	−$117.50	0.001	−$286.88	0.123
0.95	−$8,507.27	<0.001	−$1,301.93	0.001	−$110.64	0.005	−$138.18	0.486

*Total charges are estimated minus the cost of glatiramer acetate.

Results of seven generalized linear models, one each for the MPR Thresholds, with log link and gamma distribution, controlling for patient age, sex, region of residence, type of insurance coverage, and copay associated with initial use of glatiramer acetate (n = 839).

Table 3.  Association between alternative MPR threshold and MS-related total charge components.*

MPR threshold	Inpatient		Outpatient		Emergency room
	Incremental effect	p-value	Incremental effect	p-value	Incremental effect	p-value
0.10	−$1,577.10	0.172	−$808.74	0.247	$1.15	0.948
0.25	−$249.02	0.737	−$706.30	0.114	$12.91	0.248
0.50	−$2,008.98	0.001	−$564.32	0.113	$12.52	0.158
0.70	−$3,372.01	<0.001	−$655.98	0.061	$0.61	0.945
0.80	−$3,470.00	<0.001	−$646.99	0.067	$12.26	0.162
0.90	−$4,206.43	<0.001	−$655.98	0.070	−$7.98	0.380
0.95	−$4,582.77	<0.001	−$891.41	0.021	$7.45	0.440

*Total charges are estimated minus the cost of glatiramer acetate.

Results of seven generalized linear models, one each for the MPR Thresholds, with log link and gamma distribution, controlling for patient age, sex, region of residence, type of insurance coverage, and copay associated with initial use of glatiramer acetate (n = 839).