Multiple Sclerosis Patients with High Relapse Rate

Cincinnati—Relapsing-remitting multiple sclerosis (MS) is characterized by relapses of symptoms interspersed between periods of remission. Relapses can last for days, weeks, or months and are associated with significant disability and distress. Frequency of attacks is random, but previous studies have identified general attack rates of 0.1 to 1.2 per year.

Researchers recently conducted a study to identify high relapse activity (HRA) patients with multiple sclerosis (MS) and compare the differences in resource utilization and costs between patients with and without HRA. For this study, researchers defined HRA as experiencing ≥2 relapses per year.

Results were presented during a poster session at the AMCP meeting in a poster titled Resource Utilization and Costs of Multiple Sclerosis Patients With High Relapse Rate Using a Claims Database.

Using MarketScan^® Commercial Claim and Medicare Databases in a retrospective study of 19,219 participants, 94.7% had ≤2 relapses and 5.3% had ≥2 relapses in 2009. Compared with patients without HRA, patients with HRA tended to be younger (50 years vs 52 years) and less likely to be employed (50.2% vs 56.5%). Patients without HRA were more likely to report MS symptoms (82.1% vs 68.8%) and were more likely to use disease-modifying treatments (75.6% vs 68.2%; P<0.0001).

Data from the second year of the study showed patients with HRA had more all-cause (23.2% vs 11.4%) and MS-specific (7.4% vs 1.6%) hospitalizations and emergency department (ED) visits (32.8% vs 22.7% and 15.2% vs 7.6%, respectively), compared with patients without HRA.  

The results showed that mean total annual all-cause cost for HRA patients was $12,058 greater than for patients without HRA. In addition, the researchers observed that patients with HRA were more likely to be hospitalized and have ED visits than patients without HRA.

While noting that the study is limited in that it excluded costs for disease-modifying treatments, the researchers strongly concluded that patients with ≥2 relapse episodes annually have overall higher resource utilization and treating these patients tends to be more costly.

This study was supported by Novartis Pharmaceuticals.