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Adherence and persistence among multiple sclerosis patients after one immunomodulatory therapy failure: Retrospective claims analysis

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Abstract

Introduction

There are no published data on patient adherence to, and persistence with, disease-modifying therapies (DMT) for multiple sclerosis (MS) after one immunomodulatory failure. The present study compares secondline DMT adherence and persistence among patients with MS.

Methods

Patients with MS initiating a second-line treatment with natalizumab, intramuscular interferon beta-1a (i.m.-IFNβ-1a), subcutaneous (s.c.) IFNβ-1a, interferon beta-1b (IFNβ-1b), and glatiramer acetate (GA) from January 1, 2006 to October 4, 2008 were identified from a retrospective claims database associated with a large US health plan. Adherence was measured with medication possession ratio (MPR); adherence indicated MPR ≥0.80. Persistence was measured as time until a minimum 60-day gap in second-line therapy. Adherence and persistence were modeled with logistic and Cox proportional hazard regressions, respectively.

Results

The study population comprised 1381 patients. Multivariate analysis showed that the odds of adherence were significantly higher in the natalizumab cohort compared with all other second-line cohorts. The natalizumab cohort was more likely to be persistent compared with the i.m.-IFNβ-1a and IFNβ-1b cohorts.

Conclusion

The natalizumab cohort was more adherent compared with the other second-line DMT cohorts, likely due in large part to active physician involvement and monitoring. Adherence to DMT, even after first-line failure, is critical to achieving optimal therapeutic benefit.

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Author information

Authors and Affiliations

  1. Health Economics and Outcomes Research, OptumInsight, Eden Prairie, MN, USA

    Rachel Halpern & Leigh Borton

  2. Biogen Idec, Weston, MA, USA

    Sonalee Agarwal

  3. Health Economics and Outcomes Research, OptumInsight, 12125 Technology Drive, Eden Prairie, MN, 55344, USA

    Kathy Oneacre

  4. Medical and Scientific Affairs, i3 Research, Waltham, MA, USA

    Maria V. Lopez-Bresnahan

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  1. Rachel Halpern
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  2. Sonalee Agarwal
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  3. Leigh Borton
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  4. Kathy Oneacre
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  5. Maria V. Lopez-Bresnahan
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Corresponding author

Correspondence to Kathy Oneacre.

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Halpern, R., Agarwal, S., Borton, L. et al. Adherence and persistence among multiple sclerosis patients after one immunomodulatory therapy failure: Retrospective claims analysis. Adv Therapy 28, 761–775 (2011). https://doi.org/10.1007/s12325-011-0054-9

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  • DOI: https://doi.org/10.1007/s12325-011-0054-9

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