Impact of Real-World Adherence on Effectiveness of First-Line DMTs in Multiple Sclerosis (P01.215)

OBJECTIVE: To assess the impact of adherence on real-world effectiveness of first-line disease modifying treatments (DMTs) for Multiple Sclerosis (MS) treatment. BACKGROUND: Adherence to self-injectable DMTs for MS is suboptimal, which can negatively impact clinical outcomes. Assessing real-world effectiveness of DMTs must take real-world adherence into consideration. DESIGN/METHODS: This Microsoft® Excel-based model estimated the impact of adherence on real-world effectiveness of fingolimod, subcutaneous (SC) and intramuscular (IM) interferon–beta (IFN β) 1a, SC IFN β1b, and glatiramer acetate. Adherence was defined as medication possession ratio (MPR) of 80% and above. The proportions of patients adherent to therapy were estimated from a retrospective observational claims study. Annualized relapse rates (ARR) for comparators were identified from Phase 3 placebo-controlled trials. The model assumes that adherent patients would have an ARR similar to those in clinical trials. The impact of non-adherence (MPR RESULTS: The model showed that fingolimod is estimated to be the most effective DMT in real-world (ARRR: 54%), followed by SC IFNβ-1b (ARRR: 29%), SC IFN β-1a (ARRR: 28%), glatiramer acetate (ARRR: 26%), and IM IFN β-1a (ARRR: 13%). Two-way sensitivity analyses showed that fingolimod had a higher ARRR in all scenarios. CONCLUSIONS: Adherence has a significant impact on real-world effectiveness of MS treatments. Fingolimod9s high trial-based efficacy and its high observed adherence relative to self-injected DMTs contribute to its high estimated real-world RRR compared to other first-line treatments. Supported by: Novartis Pharmaceuticals Corporation. Disclosure: Dr. Raimundo has received personal compensation for activities with Novartis Pharmaceuticals Corporation as a contractor. Dr. Agashivala has received personal compensation for activities with Novartis Pharmaceutical Corporation as an employee. Dr. Kim has received personal compensation for activities with Novartis Pharmaceuticals Corporation as an employee. Dr. Kim holds stock with Novartis Pharmaceuticals and former employee stock with Bristol Myers Squibb. Dr.Brandes has received personal compensation for activities with Biogen Idec, Teva Neurosciences, Questcor, Avanir, Genzyme, Novartis as a member of the speaker9s panel and from Biogen Idec, Teva Neurosciences, Questcor, Genzyme, Novartis as a member of the advisory panel.