OBJECTIVES: To compare, using corticosteroid use as a surrogate marker for relapse activity, healthcare utilization and costs among patients with multiple sclerosis (MS) who do/do not receive disease-modifying therapy (DMT).

METHODS: Healthcare claims analysis included MS patients with or without DMT during the 12 months prior to the most recent claim, stratified by number of corticosteroid treatments (0, 1, or ≥2) during this period. Costs were assessed based on claims during the 1-year observation period.

RESULTS: Of 7072 patients covered by Medicare, 4689 (66%) received DMT. Patients with DMT were less likely to have a corticosteroid claim than patients not receiving DMT (39% vs 62%), and less likely to have an ER visit (39% vs 54%) or hospitalization episode (18% vs 29%). Overall medical costs were lower with DMT use. For patients without a corticosteroid claim, total medical costs were $8,037 for DMT vs $13,604 for no DMT; inpatient costs were $15,085 vs $20,802; ER costs were $1,204 vs $1,508. Costs rose with increased corticosteroid treatments. In patients with ≥2 corticosteroid treatments, total medical costs (DMT vs no DMT) were $13,688 vs $18,728; inpatient costs were $14,320 vs $17,890; ER costs were $1,674 vs $2,172. Rates of post-steroid DMT switching were low (12%–16%) even in patients with ≥2 episodes of corticosteroid use.

CONCLUSIONS: DMT use was associated with fewer corticosteroid treatments (potentially indicating fewer relapses), fewer hospitalization episodes, fewer ER visits, and lower medical costs, indicative of better health outcomes. DMT use lowered healthcare utilization and costs in patients with and without corticosteroid treatments. Corticosteroid treatments were associated with increasing utilization and costs, but did not prompt increased DMT switching.

STUDY SUPPORT: Sanofi