Article

Objective : To evaluate the clinical and economic impact of a specialty care
management program among patients with multiple sclerosis. This retrospective cohort analysis included patients aged > or =18 years with > or =2
claims of multiple sclerosis diagnosis and > or =1 multiple sclerosis medications
from 1 January 2004 to 30 April 2008. The outcome metrics included medication
adherence and persistence, multiple sclerosis-related hospitalization, and
multiple sclerosis-related cost. Multivariate analyses were performed to adjust
for demographics and clinical characteristics. RESULTS: Among the 3993 patients
identified, 78.3% participated in the program and 21.7% did not. Over 12 months,
medication adherence and persistence improved among participants but deteriorated
among non-participants (medication possession ratio change: +0.08 vs -0.03, p <
0.001; persistence change: +29.2 days vs -9.2 days, p < 0.001). Multiple
sclerosis-related hospitalization decreased from 9.6% to 7.1% for participants,
whereas it increased from 10.1% to 12.0% for the non-participant group (p <
0.001). Multiple sclerosis-related medical spending (non-pharmacy) decreased
among participants, but it increased among non-participants (mean: -US$264 vs +
US$1536, p < 0.001). Total multiple sclerosis-related cost for both groups
increased over time (+US$4471 vs +US$4087, p < 0.001). CONCLUSIONS: This program
was associated with improved medication adherence and persistence, reduced
multiple sclerosis-related hospitalization, and decreased multiple
sclerosis-related medical costs. Unfortunately, the cost savings in the medical
component did not offset the increased pharmacy expenditures during the 12-month follow-up period.

Langue : ANGLAIS

Tiré à part : OUI