Variation in the Use of Disease-modifying Therapies in Persons with Multiple Sclerosis by Age
Caroline Geiger1, Rongrong Wang1, Carmen Ng1
1Genentech Inc. - South San Francisco, CA
Objective:
To describe differences in MS treatment patterns by age.
Background:
Research has found that use of disease-modifying therapies (DMTs) among persons with multiple sclerosis (pwMS) declines with increasing age. However, little is known about variation in the use of specific DMTs by age.
Design/Methods:
Adult pwMS were identified in the MarketScan claims database (2017-2021). Each full calendar year of continuous eligibility after the first MS diagnosis code was identified. January 1 of each year was defined as the index date and the first DMT observed in the year was the index DMT. Uptake of any DMT and the use of specific DMTs were summarized for all included person-calendar years (PY) by year and age group (18-34, 35-44, 45-54, 55-64, and ≥65) on the index date. Each pwMS could contribute ≥1 PY to the analyses.
Results:
A total of 154,991 PY were included in the study with 32,304 unique pwMS in 2018, 38,658 in 2019, 41,957 in 2020, and 42,072 in 2021. Among all PY, the median age was 51 years, 77% were female, and 72% were commercially insured. In 2021, 57% of pwMS had ≥1 DMT observed but uptake of any DMT varied from 64% among pwMS aged 35-44 years to 31% among pwMS aged ≥65. Use of high-efficacy DMTs (heDMTs) increased over the study period and by 2021, use of heDMTs varied from 37% among pwMS aged 18-24 years to 7% among pwMS aged ≥65. In 2021, ocrelizumab was the most common index DMT among pwMS aged 18-64 years (15%) while glatiramer acetate was the most common among pwMS aged ≥65 (8%), followed by ocrelizumab (5%).
Conclusions:
These findings highlight underutilization of DMTs across all age groups. Additional research is needed to understand barriers to uptake of any DMT as well as heDMTs.