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. 2010 Aug;16(8):956-63.
doi: 10.1177/1352458510373487. Epub 2010 Jul 1.

Clinical and economic impact of a specialty care management program among patients with multiple sclerosis: a cohort study

H Tan  1 , J Yu, D Tabby, A Devries, J Singer
Affiliations

Clinical and economic impact of a specialty care management program among patients with multiple sclerosis: a cohort study

H Tan et al. Mult Scler. 2010 Aug.

Abstract

Background: To evaluate the clinical and economic impact of a specialty care management program among patients with multiple sclerosis.

Methods: This retrospective cohort analysis included patients aged > or =18 years with > or =2 claims of multiple sclerosis diagnosis and > or =1 multiple sclerosis medications from 1 January 2004 to 30 April 2008. The outcome metrics included medication adherence and persistence, multiple sclerosis-related hospitalization, and multiple sclerosis-related cost. Multivariate analyses were performed to adjust for demographics and clinical characteristics.

Results: Among the 3993 patients identified, 78.3% participated in the program and 21.7% did not. Over 12 months, medication adherence and persistence improved among participants but deteriorated among non-participants (medication possession ratio change: +0.08 vs -0.03, p < 0.001; persistence change: +29.2 days vs -9.2 days, p < 0.001). Multiple sclerosis-related hospitalization decreased from 9.6% to 7.1% for participants, whereas it increased from 10.1% to 12.0% for the non-participant group (p < 0.001). Multiple sclerosis-related medical spending (non-pharmacy) decreased among participants, but it increased among non-participants (mean: -US$264 vs + US$1536, p < 0.001). Total multiple sclerosis-related cost for both groups increased over time (+US$4471 vs +US$4087, p < 0.001).

Conclusions: This program was associated with improved medication adherence and persistence, reduced multiple sclerosis-related hospitalization, and decreased multiple sclerosis-related medical costs. Unfortunately, the cost savings in the medical component did not offset the increased pharmacy expenditures during the 12-month follow-up period.

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Figures

Figure 1.
Figure 1.
MS-related hospitalization 12-month period prior to and after index date.
Figure 2.
Figure 2.
MS-related medical and pharmacy costs 12 month period prior to and after index date.
Figure 3.
Figure 3.
MS-related total cost of care 12-month period prior to and after index date.
See this image and copyright information in PMC

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