Objective:

To evaluate telemedicine (TM) use during the COVID-19 pandemic among people with neurological disorders (pwND), including multiple sclerosis (MS), Alzheimer's disease (AD) and Parkinson’s disease (PD).

Background:

Use of TM increased during the pandemic; however, it is unclear how its use and accessibility varies among pwND.

Design/Methods:

This cross-sectional study used US PharMetrics Plus commercial claims data from January 1, 2019–December 31, 2021. TM use, identified using ≥1 current procedural terminology codes, was assessed in each study year (2019, 2020, 2021) among people with ≥1 inpatient or ≥2 outpatient diagnosis codes ≥30 days apart for MS, AD or PD. Any TM use and ND-related visits (MS, AD, PD diagnosis code within TM claim) were summarized, and characteristics of TM users vs nonusers during the pandemic (2020 and 2021) were described.

Results:

Among pwND, 0.9% (933/101,598 pwND) used TM in 2019 compared with 58.0% (55,517/95,715 pwND) in 2020 and 42.5% (46,315/109,029 pwND) in 2021. Among TM users in 2020 and 2021, the majority had ND-related TM visits (73.2% and 64.6%, respectively); the mean (SD) number of claims was 2.9 (2.8) in 2020 and 2.7 (3.0) in 2021. During the pandemic, nearly 26% of total TM visits (n=296,434) were provided by a neurologist. Mean (SD) age of TM users was similar to nonusers (60.5 [15.1] and 61.5 [15.3] years), but TM users were more likely to be female (62% vs 60%), enrolled in Medicare (33% vs 30%) and reside in western and eastern regions compared with nonusers. The proportion of pwND using TM was highest in Massachusetts (81.3%), Vermont (77.1%) and California (72.4%).

Conclusions:

About half of pwND in a commercially insured population used TM during the pandemic; its use varied most notably by region and state. Additional analyses will inform gaps in TM access and its long-term utility.