Assessing the Health Economic Outcomes from Commercially Insured Relapsing Multiple Sclerosis Patients Who Switched from Other Disease-Modifying Therapies to Teriflunomide, in the United States

Figures & data

Table 1 Patient Demographics at Index (Initiation of Teriflunomide Treatment), and Comorbidities Recorded in the 1-Year Pre-Index Period

Characteristics, Mean ± SD or n (%)	Patients N=2016
Age at index, years	51.4 ± 9.3
Age group, n (%), years
18–34	89 (4.4)
35–44	378 (18.8)
45–54	743 (36.9)
55–64	686 (34.0)
65+	120 (6.0)
Age at MS diagnosis, years	47.4 ± 9.2
Duration of disease, years	4.7 ± 2.8
Sex, n (%)
Female	1599 (79.3)
US geographic region, n (%)
North Central	486 (24.1)
Northeast	419 (20.8)
South	809 (40.1)
West	293 (14.5)
Unknown	9 (0.4)
Insurance coverage plan, n (%)
PPO	1171 (58.1)
CDHP	228 (11.3)
HMO	193 (9.6)
HDHP	106 (5.3)
Other^a	318 (15.8)
Comorbid conditions in 1-year pre-index period, n (%)
Hypertension	428 (21.2)
Hyperlipidemia	261 (12.9)
Urinary tract infection	137 (6.8)
Unspecified acquired hypothyroidism	132 (6.5)
Diabetes	128 (6.3)
Fibromyalgia/myalgia and myositis	70 (3.5)
Neuropathic pain	33 (1.6)
Arthritis^b	30 (1.5)
Charlson Comorbidity Index score, mean ± SD	0.4 ± 1.0
Common symptoms, n (%)^c
Headache (migraine)	158 (7.8)
Anxiety	150 (7.4)
Malaise and fatigue	128 (6.3)
Muscle weakness	119 (5.9)
Spasticity	112 (5.6)
Dizziness	89 (4.4)
Urinary incontinence	84 (4.2)
Optic neuritis	30 (1.5)
Major depressive disorder	29 (1.4)
Trigeminal neuralgia	20 (1.0)
Diplopia	18 (0.9)

Notes: ^aIncluding exclusive provider organization, comprehensive, point-of-service plan with capitation, point-of-service plan, or other. ^bRheumatoid arthritis and osteoarthritis. ^cReported in >10 patients (0.5%) in the pre index patients.

Abbreviations: CDHP, consumer-driven health plan; HDHP, high-deductible health plan; HMO, health maintenance organization; MS, multiple sclerosis; PPO, preferred-provider organization; SD, standard deviation.

Figure 1 Patient attrition from Merative™ (formerly IBM^®) MarketScan^® Research Database.

Table 2 Healthcare Resource Utilization Rates and Healthcare Costs per Patient per Year at 1 Year Pre Index Vs 1 Year Post Index (n=2016)

	1 Year Pre Index	1 Year Post Index	P-value
Healthcare resource utilization
All-cause services (event rate/100 person-years)
Outpatient visits per patient	0.228	0.238	<0.001
ER visits	0.007	0.007	0.742
Therapy visits^a	0.040	0.042	0.027
MRI visits	0.012	0.009	<0.001
Laboratory services	0.054	0.065	<0.001
Inpatient visits	0.007	0.007	0.636
MS-specific (event rate/100 person-years)
Outpatient visits per patient	0.088	0.092	<0.001
ER visits	0.002	0.002	0.763
Therapy visits^a	0.013	0.016	0.000
MRI visits	0.009	0.007	<0.001
Laboratory services	0.024	0.033	<0.001
Inpatient visits	0.004	0.004	0.355
Healthcare costs^b
All-cause services, $PPPY
Outpatient visits	7635	7414	0.071
ER visits	952	905	0.148
Therapy visits^a	517	570	0.437
MRI visits	1902	1375	<0.001
Laboratory services	590	529	0.009
Inpatient visits	2471	2288	0.239
MS-specific services, $PPPY
Outpatient visits	3580	3209	<0.001
ER visits	261	213	0.148
Therapy visits^a	231	341	0.034
MRI visits	1632	1213	<0.001
Laboratory services	271	248	0.020
Inpatient visits	1262	1185	0.244

Notes: All costs were adjusted to US$ 2020 using the healthcare component of the Consumer Price Index. ^aIncludes physical, occupational, speech and rehabilitation therapies, and some therapies may have been claimed as an inpatient visit. ^bTotal amount paid by insurance. P-values calculated using Wilcoxon rank-sum test.

Abbreviations: ER, emergency room; MRI, magnetic resonance imaging; MS, multiple sclerosis; PPPY, per person, per year.

Figure 2 Healthcare resource utilization in the 1-year pre- and 1-year post-index periods. (A) Frequency of all-cause and (B) MS-specific emergency room visits.

Figure 3 Average cost of disease-modifying treatments (DMTs) in the 1-year pre- and 1-year post-index periods. ^aAll costs adjusted to 2020 US dollars using the healthcare component of the Consumer Price Index. The cost of the first claim for teriflunomide is included at index. P-values calculated using Wilcoxon rank-sum test.

Figure 4 Annualized relapse rate in the 1-year pre- and 1-year post-index periods. Relapse rates compared using Poisson regression. P-values calculated using Wilcoxon rank-sum test.