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Treatment Patterns of Relapsing-Remitting Multiple Sclerosis within the High Cost Drug Law (RICARTE SOTO LAW) Program in Chile from July 2017 to November 2021

Speaker(s)

Cofre F1, Rozas MF2, Galleguillos L3, Rada A2
1Roche Chile, Santiago, Chile, 2Roche Chile, Santiago, RM, Chile, 3Clinica Alemana, Santiago RM, Chile

Presentation Documents

The Ricarte Soto Law (RSL) is a Public Health program that provides universal coverage for high-cost treatment diseases. For Relapsing-Remitting Multiple Sclerosis (RRMS), this is a “rescue” program which covers financial costs of Disease Modifying Treatments (DMT) after first-line immunomodulatorshas failed . It started in July’17 covering Natalizumab and Fingolimod. By July’19 Ocrelizumab, Alemtuzumab and Cladribine were included.

OBJECTIVE: to describe treatment patterns of RRMS patients within the RSL.

METHODS: Anonymized data from the public entity in charge of healthcare supplies (CENABAST) was analyzed from July’17 to November’21.

RESULTS: we retrieved 1355 complete records for data analysis, which represents 93,2% of total RRMS patients enrolled on RSL. From July’17 to July’19, the preferred treatment was Fingolimod (77,1%), however once other treatments became available, Ocrelizumab was preferred for newly incorporated patients to RSL (56,2%) followed by Fingolimod (16,8%). DMT was changed in 13,1% of patients. These changes were unevenly distributed, 80,3% occurred before July’19, while only 19,6% happened after that date (p-value=0.0001). For each treatment, we calculated the patient-leakage percent (n° of patients who change treatment / n° of initially treated patients), finding that Natalizumab and Fingolimod had the greatest patient-leakage with 34,5% and 24,4% respectively, followed by Cladribine (5,0%), Alemtuzumab (4,8%) and Ocrelizumab (0,6%). The patient-leakage rate (velocity of change) was more steep and relatively constant over time for Natalizumab and Fingolimod. Cladribine and Ocrelizumab had the lowest patient-leakage rates (p-value=0.00001). Of all patients that changed treatment, 62,9% were switched to Ocrelizumab followed by 16,3% that switched to Cladribine.

CONCLUSIONS: Most patients remained within the same DMT,13,1% changed therapy, mostly from Fingolimod and Natalizumab towards Ocrelizumab.. After July’19 prescribing preferences for new RRMS patients favor Ocrelizumab over Fingolimod.

Code

HSD31

Topic

Real World Data & Information Systems

Topic Subcategory

Health & Insurance Records Systems

Disease

Neurological Disorders