Abstract Details

Title Economic Burden of Multiple Sclerosis in Employees with and without Suboptimal Treatment Outcomes to Disease-Modifying Drugs: An Employer Perspective

Topic Multiple Sclerosis

Presentation(s) P8 - Poster Session 8 (8:00 AM-9:00 AM)

Poster/Presentation
Number 9-008

Objective To quantify the economic burden associated with suboptimal treatment outcomes with disease-modifying drugs (DMDs) from an employer perspective.

Background A better understanding of suboptimal treatment outcomes may elucidate opportunities for improving care management for employees with multiple sclerosis (MS).

Design/Methods US Human Capital Management Services database employees with: ≥2 MS diagnoses (ICD-9-CM code 340/ICD-10-CM code G35) from 1/1/2010–3/31/2019, ≥1 oral or self-injectable DMD claim (first=index), continuous eligibility 6-months pre-/1-year post-index, no baseline DMD, and age 18–64 were included. All-cause and MS-related medical costs and indirect costs of employees with and without suboptimal treatment outcomes (defined as DMD nonadherence [proportion of days covered <80%], DMD discontinuation [treatment gap >60 days], DMD switch, or relapse [MS-related hospitalization, emergency room visit, or outpatient visit with corticosteroid ±7 days]) were compared. A two-part logistic-GLM model controlled for age, tenure, marital status, race, exempt status, full-/part-time, salary, location, Charlson Comorbidity Index, smoking, and relapse.

Results Of 2173 employees with ≥2 MS diagnoses, 488 (22.5%) met eligibility criteria. Half (n=247; 50.6%) had an indicator for suboptimal treatment outcomes (39.5% nonadherence, 9.8% discontinuation, 10.9% switch, 20.7% relapse; not mutually-exclusive). Baseline demographic and clinical characteristics were similar between cohorts (all p>0.05). Employees with suboptimal treatment outcomes had higher all-cause medical costs ($12,730 vs. $6,428; p<0.0001), MS-related medical costs ($5,444 vs. $2,652; p<0.0001), and non-DMD pharmacy costs ($2,920 vs. $2,169; p=0.0199). Employees with suboptimal treatment outcomes also had higher sick leave ($1,247 vs. $908; p=0.0274) and short-term disability ($934 vs. $146; p=0.0001) costs compared to employees without suboptimal treatment outcomes, however, long-term disability ($751 vs. $0; p=0.1250) and Workers’ Compensation ($56 vs. $24; p=0.1276) costs were not significantly different.

Conclusions Suboptimal response to DMD treatment (ie, nonadherence, discontinuation, switch, or relapse) is associated with higher medical, sick leave, and short-term disability costs in employees with MS.

Authors/Disclosures
Carrie M. Hersh, DO, MSc, F�鶹��ýӳ�� (Cleveland Clinic Lou Ruvo Center for Brain Health) PRESENTER	Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech_GN41791. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genzyme. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol-Myers Squibb . Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Horizon Therapeutics. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Genzyme. Dr. Hersh has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. The institution of Dr. Hersh has received research support from Biogen. The institution of Dr. Hersh has received research support from Novartis. The institution of Dr. Hersh has received research support from Genentech_GN41791. The institution of Dr. Hersh has received research support from PCORI. The institution of Dr. Hersh has received research support from Bristol Myers Squibb.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Lori Lebson, PhD	No disclosure on file
	No disclosure on file
Amy L. Phillips, PharmD (EMD Serono)	Amy L. Phillips, PharmD has received personal compensation for serving as an employee of EMD Serono, Inc.

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