Assessing the Health Economic Outcomes from Commercially Insured Relapsing Multiple Sclerosis Patients Who Switched from Other Disease-Modifying Therapies to Teriflunomide, in the United States.
| Autor: | Araujo L; Neurology and Immunology, Sanofi, Cambridge, MA, USA., Kyatham S; Axtria Inc, Berkeley Heights, NJ, USA., Bzdek KG; Neurology and Immunology, Sanofi, Cambridge, MA, USA., Higuchi K; Neurology and Immunology, Sanofi, Cambridge, MA, USA., Greene N; Neurology and Immunology, Sanofi, Cambridge, MA, USA. |
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| Jazyk: | angličtina |
| Zdroj: | ClinicoEconomics and outcomes research : CEOR [Clinicoecon Outcomes Res] 2023 May 20; Vol. 15, pp. 361-373. Date of Electronic Publication: 2023 May 20 (Print Publication: 2023). |
| DOI: | 10.2147/CEOR.S401687 |
| Abstrakt: | Objective: Assess patient characteristics, healthcare resource utilization (HCRU), and relapses in patients with multiple sclerosis (MS) who switched to teriflunomide from other disease-modifying therapies (DMTs). Methods: Retrospective study of US Merative™ MarketScan ® claims database (Jan 1, 2012-July 31, 2020,) including HIPAA-compliant, deidentified data. Patients ≥18 years with MS diagnosis (based on ICD-9/ICD-10 codes), receiving ≥1 DMT prior to teriflunomide and ≥12 months continuous enrollment pre and post index (date of teriflunomide initiation). Outcomes included inpatient and emergency room claims coinciding with MS diagnosis, MS-related healthcare costs, and annualized relapse rates (ARRs) (indirectly assessed using hospitalization/outpatient claims and steroid use coinciding with MS diagnosis). Results: The analyzed cohort (N=2016) was primarily female (79%); age (mean ± standard deviation) 51.4 ± 9.3 years; MS duration 4.7±2.8 years (at index). The majority (89.2%) were treated with one DMT before switching to teriflunomide. Use of outpatient services (event rate/100 person-years) increased post vs pre index; however, MRI visits significantly reduced over the same period (both P <0.0001). Costs for MS-specific outpatient visits decreased by $371 per patient per year (PPPY) after switching to teriflunomide. Despite an increase in use post index (0.024 to 0.033 rate/100 person-years; P <0.0001), costs for MS-specific laboratory services reduced (pre-index: $271 vs $248 PPPY post-index; P =0.02). Fewer patients had relapses after switching (pre-index: n=417 [20.7%]; post-index: n=333 [16.5%]). ARR was significantly lower after switching (pre-index: 0.269 vs post-index: 0.205; P =0.000). Conclusion: Switching to teriflunomide from existing DMTs in patients with relapsing MS resulted in a reduction in outpatient HCRU in this analysis of US claims data. The real-world effectiveness of teriflunomide was generally consistent with efficacy reported in clinical trials, showing a reduction in relapse following a switch to teriflunomide. Competing Interests: Lita Araujo, Keiko Higuchi, and Nupur Greene are employees of Sanofi and may hold stock or stock options. Kristen G Bzdek was an employee of Sanofi at the time of the study. Srikanth Kyatham was an employee of Axtria at the time the study was conducted. Axtria was a paid consultant to Sanofi in relation to this project. (© 2023 Araujo et al.) |
| Databáze: | MEDLINE |
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