Comorbidity Patterns in Patients With MS Vary With Insurance Type

Patterns of comorbidities and multimorbidities differed between patients with multiple sclerosis (MS) who had commercial insurance and those who had Medicare Advantage insurance, according to a study published in the Journal of Health Economics and Outcomes Research.

“Published evidence comparing patient characteristics, comorbidities, and multimorbidity patterns of commercially insured vs Medicare Advantage enrollees with MS is lacking,” researchers explained in the study background. “Such knowledge may be important in optimizing disease management and clinical outcomes and minimizing health care costs.”

The retrospective, observational study investigated comorbidity and multimorbidity patterns using Aetna health claims data for 5000 people with MS. Among them, 53% had commercial insurance and 47% had Medicare Advantage insurance. Researchers compared patients with commercial insurance, patients with Medicare Advantage who were younger than 65, and patients with Medicare Advantage who were 65 or older.

Compared with patients with commercial insurance, whose average age was 45.7, patients with Medicare Advantage were older: average ages were 53.3 in the under-65 group and 70.8 in the 65-or-older group. Patients with Medicare Advantage also had a greater comorbidity burden. Charlson Comorbidity Index scores were 1.17 in the under-65 group and 1.65 in the 65-or-older group compared with 0.53 in the commercial insurance group, according to the study.

MS-specific symptoms, such as malaise, fatigue, depression, spasms, fibromyalgia, and convulsions, were more common among Medicare Advantage patients aged younger than 65 years. Age-related and other comorbidities—such as hypertension, hyperlipidemia, dyspepsia, osteoarthritis, osteoporosis, glaucoma, diabetes, cerebrovascular, and cancer—were more common among Medicare Advantage patients 65 years and older. Meanwhile, burning, numbness, and tingling were more common among patients with commercial insurance.

Overall, the median number of comorbidities was 4, researchers reported. Medians were higher, however, in the Medicare Advantage groups: 6 among beneficiaries younger than 65, and 7 among beneficiaries 65 and older.

“Multimorbidity is highly prevalent among patients with MS,” the authors advised, “and should be considered in the context of clinical decision making to optimize MS management and improve patient outcomes.”

Reference:
Dai D, Sharma A, Phillips AL, Lobo C. Patterns of comorbidity and multimorbidity among patients with multiple sclerosis in a large US commercially insured and Medicare Advantage population. J Health Econ Outcomes Res. 2022;9(2):125-133. doi:10.36469/001c.38669