Comparison of Costs and Health Resource Utilization inPatients Treated with Different Disease Modifying Therapies for MultipleSclerosis (P3.082)

OBJECTIVE: To compare change in costs and health resource utilization of multiple sclerosis (MS) patients who initiated delayed-release dimethyl fumarate (DMF), glatiramer acetate (GA), interferons (INF), fingolimod (FTY), or teriflunomide (TFM). BACKGROUND: Disease modifying therapies (DMTs) have dramatically changed the management MS. However, Published literature is limited on the relative economic outcomes of different DMTs in a real-world setting. DESIGN/METHODS: A large administrative claims database from commercially-insured individuals was used to identify MS patients (18-64 years) initiating a DMT of interest between 01/01/2013-09/30/2013 (date of first DMT denoted as index date). Patients were excluded if they took any DMT in the year prior to the index date. Total healthcare cost and non-prescription medical cost were compared for one year pre- and post-the index date. Difference-in-differences estimate was used to assess the difference in cost between DMF and other DMTs over time adjusting for demographics and Charlson Comorbidity Index (CCI). RESULTS: A total of 755, 684, 628, 159, and 138 DMT-untreated patients initiated DMF, GA, INF, FTY, and TFM, respectively. Proportion of female (76.6[percnt]-87.0[percnt]) and CCI (0.54-0.77) across groups were similar (both p>0.05) while difference was seen in age (45.7, 43.2, 43.9, 45.0, and 48.9, p<0.001) and annual healthcare cost before the index date ($22,612, $16,731, $16,657, $20,518, and $22,427, p<0.001). Total annual healthcare cost increased by $38,801, $44,923, $45,201, $52,352, and $43,216 after the initiation of DMF, GA, INF, FTY, and TFM, respectively (p<0.001). Among these groups, the reduction in annual non-prescription medical cost was $6,638, $1,099, $3,030, $6,381, and $387 (p<0.01). The difference between DMF and other DMTs remains consistent after controlling for confounders. CONCLUSIONS: DMF demonstrated favorable economic outcomes for untreated MS patients; it had the lowest increase in total healthcare cost and the highest reduction in non-prescription medical cost among the DMTs compared. Disclosure: Dr. Nicholas has received personal compensation for activities with Biogen Idec, PeerView CME, Medtronic, Inc., Novartis, Genzyme and Teva as a honorary speaker and consultant. Dr. Boster has received personal compensation for activities with Merck Serono, Biogen, Novartis, Sun-Pharma, Roche, Genetech, National MS Society, NIH, and Medtronic as a consultant. Dr. Yeh holds stock and/or stock options in Biogen Idec. Dr. Garland holds stock and/or stock options in Biogen, which sponsored research in which Dr. Garland was involved as an investigator. Dr. Fay has received personal compensation for activities with Biogen Idec as an employee. Dr. Iyer has received personal compensation for activities with Biogen as an employee. Mr. Lee has received personal compensation for activities with Biogen as an employee.