OBJECTIVES: With varying availability of data among real-world data (RWD) sources, the linkage of databases can expand real-world evidence opportunities in multiple sclerosis (MS). We introduce a novel linked database via a use case combining the strengths of claims and MS registries.

METHODS: The German AOK PLUS sickness fund and the Multiple Sclerosis Management System 3D (MSDS-3D) at the Center for Neuroscience (ZKN) in Dresden were used to generate a linked database (MSDS-AOK PLUS). AOK PLUS provides a full record of diagnoses, treatment, and healthcare resource use and costs. Disease severity factors are supplemented by MSDS-3D, which documents clinical information such as functional performance including the expanded disability status scale (EDSS). We recruited MS patients documented in MSDS-3D and insured by AOK PLUS. We selected patients who had at least 1 EDSS score between 01/10/2015-30/06/2019 and were continuously insured in the year after the first documented EDSS (index). Costs of all-cause and MS-specific (main/primary diagnosis ICD-10: G35.-) hospitalizations were assessed by EDSS in the year after the index.

RESULTS: Overall, 158 continuously insured patients with at least 1 EDSS score were included (mean age 47.5 years, 76.6% female). At index, 77.2%, 10.8%, and 5.7% of patients had RRMS, SPMS, and PPMS, respectively. Across all patients, the index EDSS ranged from 1.0 to 8.0 (mean 3.2). The highest mean costs observed were €3,522.24 (SD 4,458.21) and €3,167.52 (SD 4,947.64) for all-cause hospitalizations, and €3,236.24 (SD 4,562.64) and €2,998.08 (SD 4,961.75) for MS-specific admissions among patients with EDSS 6‑6.5 and EDSS 4‑4.5, respectively.

CONCLUSIONS: The combination of clinical factors and resource use across different settings in the MSDS-AOK PLUS database presents a novel opportunity in MS research. The linked database can be used for a variety of RWD studies, including comparative or cost effectiveness, outcome measure validation, and understanding disease behavior.