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PND63 IMPACT OF ORAL DISEASE MODIFYING MEDICATION UTILIZATION ON MULTIPLE SLCEROSIS TREATMENT LANDSCAPE: TRENDS OVER THE PAST DECADE

      Objectives

      Treatment options for relapsing-remitting multiple sclerosis (MS) have expanded rapidly over the past decade. This study examined trends in medication utilization among MS patients living in the U.S. from 2010 to 2015.

      Methods

      This retrospective analysis utilized the IBM®MarketScan®Research Database spanning 2009-2017. Incident MS patients were identified via ICD-9 and ICD-10 diagnosis codes and were required to evidence continuous enrollment for at least 6 months prior to and 24 months following the initial diagnosis. Utilization of interferon beta products (IFN), glatiramer acetate (GA), biologics (ocrelizumab, alemtuzumab, and natalizumab) and oral medications (dimethyl fumarate, fingolimod, and teriflunomide) were assessed during the 24-month follow-up period. The proportion of patients utilizing specific agents was examined as a function of diagnosis year; odds ratios (OR) were calculated for the likelihood of treatment class utilization with year 2010 as the reference. The relationship between year of diagnosis and time to treatment class initiation was assessed via linear regression.

      Results

      From 2010 to 2015, there were significant decreases in IFN (32.4% vs. 9.9%; OR 0.23, 95% confidence interval [CI] 0.20-0.27) and GA utilization (28.7% vs. 22.8%; OR 0.73, 95% CI 0.65-0.84; ps < 0.001), with biologic utilization remaining unchanged (6.6% vs. 7.1%; OR 1.08, 95% CI 0.86-1.35, p > 0.05), and utilization of oral treatments increasing (15.9% vs. 26.0%; OR 1.85, 95% CI 1.61-2.14, p < 0.001). Additionally, from 2010 to 2015, time to IFN treatment initiation increased significantly (97±145 vs. 151±168 days), while the time to initiation of oral medications decreased (381±191 vs. 173±191 days, ps < 0.001).

      Conclusions

      The release of oral medications coincided with a notable shift in the treatment of MS over the study period. From 2010 through 2015 treatment with IFN and GA declined in concert with an increase in the use of newer oral drugs.