Abstract Details

Title Gaps in treatment and treatment discontinuation among patients with multiple sclerosis newly-initiating once- or twice-daily oral disease-modifying drugs

Topic Multiple Sclerosis

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-102

Objective To describe lapses in therapy (gaps) and treatment discontinuation among US patients with multiple sclerosis (MS) newly-initiating once- or twice-daily oral disease-modifying drugs (DMDs).

Background Studies evaluating gaps in therapy and treatment discontinuation with oral DMDs are scarce.

Design/Methods This retrospective administrative claims study used data from the IQVIA™ RWD Adjudicated Claims - US database from 7/1/2012–6/30/2017. Eligibility criteria were: ≥2 MS diagnosis claims (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9 CM] code: 340.xx and ICD-10 CM code: G35) between 7/1/2013–6/30/2015, ≥1 once- or twice-daily oral DMD claim between 7/1/2013–6/30/2015, continuous eligibility with commercial insurance 1 year before (baseline) and 2 years after (follow-up) oral DMD initiation, no oral DMD use during baseline, and age 18–63 years. The longest gap was the number of days between the lapsing of days’ supply of the prior prescription and fulfillment of a new prescription. Discontinuation reflected patients stopping the oral DMD for a minimum of 60 days and not re-starting it (ie, discontinuing treatment or switching therapy).

Results A total of 4,193 patients met the eligibility criteria. Mean (Standard Deviation [SD]) age was 45.4 (9.9) years and 76.3% were female. The mean (SD) duration of longest gap was 35.6 (62.7) days. Study patients were distributed among the longest gap categories as follows: 0–<15 days: 44.6%; 15–<30 days: 25.6%; 30–<45 days: 11.0%; 45–<60 days: 5.2%; 60–<75 days: 3.5%; 75–<90 days: 1.7%; and 90+ days: 8.3%. Discontinuation of oral DMD treatment was observed in 45. 2% of patients and mean (SD) time to discontinuation was 249.0 (189.8) days.

Conclusions A longest gap in therapy of 30 days or more during treatment (29.8%) and discontinuation of the index DMD (45.2%) was common among patients with MS newly-initiating once- or twice-daily oral DMDs during the 2-year observation period.

Authors/Disclosures
Jacqueline A. Nicholas, MD (OhioHealth Riverside Methodist Hospital) PRESENTER	Dr. Nicholas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Nicholas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Nicholas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Nicholas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squib. Dr. Nicholas has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Nicholas has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Nicholas has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Greenwich Biosciences. Dr. Nicholas has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Nicholas has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Nicholas has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for EMD Serono. Dr. Nicholas has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Genentech. Dr. Nicholas has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Dr. Nicholas has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Vielo Bio. Dr. Nicholas has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb. The institution of Dr. Nicholas has received research support from Novartis. The institution of Dr. Nicholas has received research support from Biogen. The institution of Dr. Nicholas has received research support from Genentech. The institution of Dr. Nicholas has received research support from PCORI. Dr. Nicholas has a non-compensated relationship as a Physician with National MS Society that is relevant to AAN interests or activities. Dr. Nicholas has a non-compensated relationship as a Physician with Siegal Rare Neuroimmune Association that is relevant to AAN interests or activities.
	No disclosure on file
Danielle E. Harlow, PhD	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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