To analyze health care utilization among a high risk, underserved, and socioeconomically challenged population. To quantify patterns of disease modifying therapy utilization and association with disability, hospitalizations, and resource utilization.

Most of the current population health data regarding Multiple Sclerosis is based on patients with commercial health insurance. Our county hospital serves as a safety net for patients who are socioeconomically challenged and those who have poor access to care. These patients are a high risk population for disability due to limited access to care and socioeconomic challenges. Access to disease modifying therapy is a crucial intervention in preventing disability accrual. The 2018 Â鶹´«Ã½Ó³»­ Summary of Practice Guidelines provided level B evidence for the use of alemtuzumab, fingolimod or natalizumab for patients with highly active MS. With the most recent approval of B-cell targeted therapies we would add ocrelizumab or rituximab to this group. 

Analysis of 6 months of visit data (April 2019 to October 2019) demonstrate that there were 449 patients on disease modifying therapy. Of these only 22% (n=97) were on alemtuzumab, fingolimod or natalizumab. This number increased to 38% (n=171) when including B-cell targeted therapies.

Initial results show that the majority of our high risk patients are not on highly efficacious medications. We will present data relative to race, gender, and access to care encounters. We will present outcome data relative to therapy prescribed.