OBJECTIVES: To describe real-world dosage and adherence to nabiximols, an anti-spasticity medication (ASM), and treatment patterns among patients with multiple sclerosis (MS).

METHODS: A retrospective cohort study of anonymized patient data, extracted from the InGef German administrative claims database. Eligible patients had ≥1 MS diagnosis 1 year before or on the date of nabiximols initiation (index date), ≥1 nabiximols dispensation on or after January 1, 2015, and were observable in the database for the 1 year before index date (pre-index period). Treatment patterns (e.g., switching, ASM history) before and after receiving nabiximols, dosage, and adherence were summarized using descriptive statistics. Dosage was based on the number of bottles dispensed per patient over the treatment period. Number of sprays per day was estimated assuming 1 bottle equaled 90 sprays. Adherence was based on proportion of days covered (the sum of days covered divided by the treatment period).

RESULTS: Of 837 patients, mean age (SD) was 51.5 (11.2) years, 61% were female, and 74% had progressive MS. 43% of patients had no documented ASM 1 year before nabiximols initiation. Baclofen was the most common ASM (40%) before nabiximols initiation. 90% of patients initiated nabiximols as monotherapy (no other ASM within 30 days of nabiximols initiation). Mean (SD) and median (IQR) number of nabiximols bottles dispensed per year was 27.5 (18.9) and 29.6 (24.0-29.6), respectively. Mean (SD) and median (IQR) number of nabiximols sprays per day was 6.8 (4.7) and 7.3 (5.9-7.3), respectively. During the treatment period, mean adherence to nabiximols was 90%; 76% of patients were ≥80% adherent.

CONCLUSIONS: In this German claims analysis of patients with MS, nabiximols adherence was high, and dosage was lower than in nabiximols pivotal trials among patients with MS spasticity. However, it could not be ascertained if all patients in this study had spasticity or received nabiximols for MS spasticity.