Objective:

Background:

Ocrelizumab is a high-efficacy monoclonal antibody prescribed for treatment of relapsing-remitting and primary progressive multiple sclerosis. Anecdotally, there are numerous cases in which patients prescribed disease-modifying therapy do not receive their first dose until months after initial prescription. Currently, no set standard exists for time from initial prescription to treatment.  Understanding of the factors leading to delay is limited in the literature.

Design/Methods:

We performed a retrospective chart review of 90 patients who received their first ocrelizumab infusion between October 2023 and November 2024 at a Michigan Medicine infusion center. The primary outcome is the average number of days between initial ocrelizumab order to first infusion. Factors contributing to delays were identified via chart review as a secondary outcome and in a qualitative analysis.

Results:

The average number of days between initial ocrelizumab order to first infusion was 56.6 days. 19 of the 90 individuals who received ocrelizumab greater than 60 days after initial order date were studied as a subset. Of these 19 individuals, 79% were female and 21% were male. 42% had a documented insurance barrier and 47% had listed a socioeconomic barrier around their multiple sclerosis care. 47% delayed their infusion due to preference. 16% were delayed due to lab monitoring.

Conclusions:

Patients who received their first dose of ocrelizumab over 60 days after the initial order were delayed at least in part due to insurance barriers, lab monitoring, and patient preferences. Almost half of patients had reported at least one socioeconomic barrier. This study highlights the importance of identifying factors that contribute to delays in treatment to provide areas for intervention.