Clinical and Economic Impact and Treatment Patterns in People With Secondary Progressive Multiple Sclerosis: A Retrospective Cohort Study in the United States
Nupur Greene1, Ashis Das2, Eunice Chang2, Marian Tarbox2, Michael Broder2
1Sanofi, 2ADVI Health
Objective:
To evaluate the real-world clinical and economic impact and treatment patterns in people with secondary progressive multiple sclerosis (SPMS) in the United States (US).
Background:
SPMS is characterized by insidious disability accumulation, with or without relapses. The evidence on SPMS-related clinical and economic burden, and its treatment patterns is limited.
Design/Methods:
A retrospective cohort study was conducted using a US-claims database from 01/01/2018 to 06/30/2023. Adult people diagnosed with SPMS were required to be enrolled in a health plan throughout the 2-year observation period. Baseline demographics, comorbidities, healthcare resource utilization (HCRU), healthcare costs (HCCs; adjusted to 2023 US-dollars), and treatment patterns were analyzed descriptively.
Results:
The study included 4,587 people with SPMS (mean±standard deviation [SD] age, 57.8±10.1 years; female, 76.9%; commercially insured, 73.5%). The mean±SD Charlson Comorbidity Index score was 2.0±2.4, while infections were reported in 80.5% of people with SPMS. The top three most common MS-related comorbidities were abnormal gait (63.9%), malaise/fatigue (54.7%), and depression (37.2%). The mean±SD Kurtzke Functional Systems adapted disability score was 4.7±1.9. During the observation period, all-cause hospitalizations were recorded in 30.9% of the cohort, while 44.8% had an emergency department visit. Occupational and physical therapies were received by 71.2% and 62.8% of people with SPMS, respectively, while 68.3% required ambulatory devices. The total mean all-cause HCCs was $168,895, primarily attributable to the costs of medical claims ($97,590) and outpatient pharmacy claims ($71,306). At baseline, 2,938 (64.1%) people with SPMS were on disease-modifying therapy (DMT) and 1,569 (34.2%) were not on any DMT. The top 3 most common observed DMTs during the observation period were ocrelizumab (22.8%), glatiramer acetate (10.0%), & dimethyl fumarate (9.2%).
Conclusions:
People with SPMS exhibit a high clinical and economic burden, underscoring the need for more effective treatments in this population with limited therapeutic options currently indicated primarily for active SPMS.
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