Disease Modifying Therapy in Newly Diagnosed People with Multiple Sclerosis – A Real-World Administrative Claims Study
Kesshi Jordan1, Heather Hua1, Ati Ghoreyshi1, Michael Edgeworth1
1Octave Bioscience
Objective:
To characterize the initial disease modifying therapy (DMT) and time-to-treatment of people who receive a diagnosis of Multiple Sclerosis (MS).
Background:
Initiation of DMT expeditiously after diagnosis is important to reduce disease activity and optimize clinical outcome. MS diagnosis can occur in emergency, inpatient, or outpatient settings so a comprehensive view of subsequent care and treatment can be difficult to ascertain. Administrative claims are a useful tool to observe initiation of care.
Design/Methods:
Longitudinal data of suspected newly diagnosed people with MS (PwMS) from a large payer commercial claims database spanning 2016-2021 were analyzed. Inclusion criteria required any combination of 3 non-overlapping claims with an MS diagnosis (ICD-10-CM: G35) and/or DMT within a year following the first G35. A minimum 5 years of continuous medical and prescription coverage with 2 years prior to and 1 year following the first G35 was required to establish likely initial diagnosis and observe initiation of DMT. Time-to-treatment statistics were calculated for DMTs initiated within a year of the first G35.
Results:
Out of 2,024 cohort members meeting inclusion criteria, 17% started a DMT within 30 days of first MS diagnosis code, and an additional 16% started between 31 and 60 days. 34% of members in this cohort did not have a DMT claim observed in the year following their initial G35. Time-to-treatment varies by DMT. The most frequent therapies initiated within a year were glatiramer acetate, dimethyl fumarate, and ocrelizumab with median (interquartile range) time-to-DMT of 35 (15-70), 47 (22-85), and 79 (51-131) days, respectively.
Conclusions:
Many apparent newly diagnosed PwMS did not start a DMT within a year following the initial MS claim. There is substantial variation in initial DMT and time-to-DMT of those that started within a year. Further study is warranted to understand factors that impact initiation of DMT.