OBJECTIVES: Disease-Modifying Agents (DMA) have been discovered and approved for patients with relapsing remitting multiple sclerosis and clinically isolated syndrome. Insurance status of patients can influence their prescribers’ clinical decision making. Our objective is to determine the use and prescribing patterns of DMAs in MS patients based on payer type and when stratified by prescriber’s specialty

METHODS: This study utilized the 2007-2016 National Ambulatory Medical Care Survey (NAMCS) data. The study sample included office visits by adults with a primary diagnosis of MS (identified by International Classification of Disease [ICD-9/10-CM] code: 340 and G35). Study population included any outpatient office-based visits by adults ≥18 years of age with a primary diagnosis of MS between the years of 2007 and 2016.

RESULTS: A total estimated 11.75 million outpatient visits, which are the primary diagnosis of MS, were made from 2007 to 2016. For our period of analysis, Interferon, an injectable DMA, is the most prescribed DMA across all payer type categories used in the study (33.47%). Our results indicate that patients with Medicare insurance status have higher odds (AOR 3.46 CI 1.96-6.11) and those who are on Medicaid plan have lower odds (AOR 0.72 CI 0.35-1.46) of being prescribed a DMA than patients who are on private insurance plans. Additionally, when stratified by prescriber’s specialty, neurology specialty has over 20 times odds of prescribing a DMA to MS patients (AOR 37.87 CI 22.87-62.71) than other non-neurology specialties when adjusted for other covariates.

CONCLUSIONS: There are differences in DMA use and prescription patterns based on payer type and prescriber’s specialty using the NAMCS database from 2007 to 2016. Interferon, an injectable DMA, is the most prescribed DMA across payer type and specialty. Prescribers in neurology specialty are more likely to prescribe a DMA to MS patients than those in non-neurology specialties.