TOPLINE:

Annual out-of-pocket costs for multiple sclerosis (MS) care in the US increased by 125% from 2002 to 2021, primarily driven by newer disease-modifying therapies (DMTs), a new study showed.

METHODOLOGY:

• Researchers conducted a cross-sectional study using data from MarketScan, a US health insurance database generalizable to approximately 55% of individuals with employer-based insurance, from 2002 to 2021.
• They assessed nearly 200,000 patients younger than 65 years with MS (median age, 48 years); most patients were included in at least 4 years of analysis.
• Annual out-of-pocket and total healthcare costs were evaluated for each patient and categorized into DMT-related and non-DMT-related prescriptions, hospitalizations, and outpatient costs.

TAKEAWAY:

• Annual out-of-pocket costs for MS care increased by 125% from $1783 per patient in 2002 to $4016 per patient in 2021 (P < .001 for trend); DMT-related out-of-pocket costs had the largest relative growth at 818% (from $228 to $2093; P < .001 for trend).
• DMT-related costs accounted for 13% of out-of-pocket costs in 2002 vs 52% in 2021.
• Annual total healthcare costs increased by 209% from 2002 to 2021 (P < .001 for trend), with DMT-related expenses accounting for 87% of this increase.

IN PRACTICE:

“To our knowledge, this was the first study to evaluate long-term trends in healthcare costs among US patients living with MS,” the investigators wrote.

“Reducing out-of-pocket barriers to DMT access may enhance affordability, facilitate uptake of more effective therapies, and generate broader, more equitable individual and societal benefits through improved disease control and mitigation of long-term disability,” they added.

SOURCE:

This study was led by Mackenzie Henderson, PharmD, Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey. It was published online on December 08 in JAMA Neurology.

LIMITATIONS:

Study limitations included potential constraints in generalizability to publicly insured patients and the absence of information regarding patient assistance programs, manufacturer coupons, rebates, and out-of-pocket payments made outside the scope of insurance claims.

DISCLOSURES:

Several investigators reported having financial or other ties with various organizations, including pharmaceutical companies. Full details are provided in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.