Characteristics and Treatment Patterns of Patients Initiating Cladribine Tablets: A U.S. Commercial and Medicare Advantage Prescription Drug Claims Analysis

Author(s)

Trenz H1, Liu M2, Allenback G1, Phillips A3, Lobo C4
1Optum, Eden Prairie, MN, USA, 2Optum, sammamish, WA, USA, 3EMD Serono, Inc. (an affiliate of Merck KGaA), Chattanooga, TN, USA, 4EMD Serono, Inc. (an affiliate of Merck KGaA), Rockland, MA, USA

OBJECTIVES: To evaluate patient characteristics and treatment patterns prior to initiating cladribine tablets (CladT).

METHODS: This retrospective study used administrative claims and sociodemographic data from commercial and Medicare Advantage Prescription Drug (MAPD) enrollees in the US Optum Research Database. Patients with ≥1 CladT claim from 4/1/2019–09/30/2020 (CladT initiation=index date), ≥1 multiple sclerosis (MS) diagnosis from 4/1/2018–09/30/2021, continuous insurance 12 months prior to (baseline period) and after (follow-up period) the index date, and age ≥18 years were included. Patient characteristics evaluated were age, sex, geographic region, insurance type, index year, comorbidities, MS severity, MS symptoms, baseline disease-modifying therapy (DMT) use, and number of baseline DMTs.

RESULTS: Among 201 patients with ≥1 CladT claim, 113 met inclusion criteria. Mean (SD) age was 52.0 (11.6) years (42.5% aged <50 years), 75.2% were female, geographical distribution was 62.8% South, 17.7% Midwest, 13.3% West, and 6.2% Northeast, 52.2% had MAPD, and 47.8% had commercial insurance. Common comorbidities were hypertension (31.9%), depression (31.0%), dyslipidemia (27.4%), anxiety disorder (23.9%), and chronic lung disease (15.0%). During the baseline period, 9.7% used a cane/walker/hospital bed/wheelchair, 11.5% had been hospitalized, and 39.8% had an MS relapse. MS symptoms included fatigue/malaise (52.2%), bladder/bowel or sexual dysfunction (48.7%), paralysis/spasticity (29.2%), walking/gait problems (28.3%), vertigo/dizziness/facial pain (26.6%), movement disorders/ataxia/tremor (25.7%), eye symptoms (16.8%), and sensory problems (16.8%). Most patients had moderate MS severity (46.9%), followed by low (35.4%) and high (17.7%) severity. Nearly two-thirds of patients had a non-CladT DMT during the baseline period (65.5%; mean [SD] DMT count was 0.73 [0.60]). The most common 1-year pre-index DMTs were dimethyl fumarate (13.3%), ocrelizumab (12.4%), natalizumab (12.4%), teriflunomide (10.6%), fingolimod (8.9%), glatiramer acetate (7.1%), and subcutaneous interferon beta-1a (5.3%).

CONCLUSIONS: These results provide a better understanding of the real-world patient characteristics and treatment patterns among US patients initiating CladT.

Conference/Value in Health Info

2022-11, ISPOR Europe 2022, Vienna, Austria

Value in Health, Volume 25, Issue 12S (December 2022)

Code

HSD63

Disease

STA: Drugs

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