OBJECTIVES : This study examined the short-term disability (STD) and long-term disability (LTD) burden (as measures of severe productivity loss) among employees with multiple sclerosis (MS) initiating disease-modifying treatments (DMTs).

METHODS : Using the IBM MarketScan Commercial Claims and Health and Productivity Management Database, patients with ≥2 new MS claims (≥1 and <365 days apart) between January 1, 2009, and January 1, 2017, and 1 subsequent claim for a DMT (index date) were identified. Patients had ≥12 months of continuous enrollment pre-index, ≥1 full calendar year of STD and/or LTD eligibility (accessible to active employees only), and no evidence of pregnancy or malignancy during the study period. The number and duration of all STD and/or LTD claims were captured during all calendar years of follow-up.

RESULTS : A total of 3,023 patients initiating orals (25.5%), injectables (64.1%), or infusions (6.1%) were identified (mean age: 41.4 years; female: 62.1%). In the first year, the percentage of patients with STD claims was generally similar across routes of administration (total: 23.2%; orals: 21.7%; injectables: 23.4%; infusions: 27.7%), as were STD days per patient with a claim (68.8, 69.9, 68.8, and 64.6 days, respectively). Percentages of patients with LTD claims were low (total: 3.1%; orals: 3.7%; injectables: 2.9%; infusions: 2.8%). Oral DMT initiators had the lowest number of LTD days per patient (31.7 days), with a numerically lower number of days compared with infusions (45.8 days) and a significantly lower difference compared with injectables (76.3 days; P=0.0307).

CONCLUSIONS : Productivity loss burden was high in the first year in MS patients. Oral DMT initiators had the lowest percentage of short-term disability claims and days per long-term disability claim, suggesting productivity benefits in severe productivity loss with early access to orals. Additional research is needed to better quantify this benefit.