REAL WORLD EVIDENCE (RWE) ON LONG-TERM PERSISTENCE OF FINGOLIMOD IN RELAPSING-REMITTING MULTIPLE SCLEROSIS (RRMS) IN AUSTRALIA

Author(s)

Schulz M¹, Arora B¹, Walker R¹, Verhaeghe S¹, Chung E², Juneja P², Spelman T³, Butzkueven H⁴, Broadley S⁵
¹Novartis Pharmaceuticals Australia, Macquarie Park, NSW, Australia, Sydney, Australia, ²Prospection Pty Ltd, Australian Technology Park, Eveleigh, NSW, Australia, Sydney, Australia, ³Karolinska Institutet, Stockholm, Sweden, ⁴Royal Melbourne Hospital, Melbourne, Australia, ⁵Griffith University, Gold Coast, Australia

Presentation Documents

PND8--strong-u-schulz-m-u-sup-1-sup-strong-arora-b-sup-1-sup-walker-r-sup-1-sup-verhaeghe-s-sup-1-sup-chung-e-sup-2-sup-juneja-p-sup-2-sup-spelman-t-sup-3-sup-butzkueven-h-sup-4-sup-broadley-s-sup-5-sup-br-sup-1-sup-novartis-pharmaceuticals ...

OBJECTIVES: This study aimed to examine and compare patient persistence of fingolimod to all reimbursed disease modifying therapies (DMTs) for relapsing-remitting multiple sclerosis (RRMS) in Australia.

METHODS: The Australian Government Medicare Database was used in this study. For patients to be eligible for the study they needed to have received a script for a reimbursed MS disease modifying therapy between September 2011 and February 2016. Persistence was defined as a patient that remained on a DMT with a gap in scripts of no longer than 4 months. Individual patients could be included multiple times if they initiated a new DMT during the study period. Persistence was derived using Kaplan-Meier method and hazard ratios (HR). Persistence to individual treatments was compared to the average persistence observed across all treatments; p-values were based on the log-rank test.

RESULTS: A total of 720 unique patients were eligible for the study. The majority were female (73.5%) and aged between 36-65 (64%). These patients contributed 1827 observations that were used for analysis (i.e. 2.5 new initiations/patient). Overall the median persistence (MP) to therapy was 29.6 months with 67.7% of patients remaining on therapy for 12 months. The only DMT that had significantly better persistence compared to the overall average, was fingolimod (HR 0.65 (95%CI: 0.57-0.73; p<0.001). Patients had an MP of 60 months on fingolimod and 79.5% of patients were persistent at 12 months. Patients were significantly less persistent to interferon Beta-1a (MP: 9.8-11.0 months), interferon Beta-1b (MP: 8.8 months), glatiramer acetate (MP: 11.4 months) and dimethyl fumarate (MP: 19.2 months) (hazard ratios above 1.27 (p values all ≤ 0.001) whilst the remaining DMTs, teriflunomide (MP: 27.7 months) and natalizumab (MP: 34.3 months), showed no significant difference from the average persistence.

CONCLUSIONS: In this Australian Medicare utilization data, patients were most persistent to fingolimod treatment amongst all DMTs.

Conference/Value in Health Info

2017-11, ISPOR Europe 2017, Glasgow, Scotland

Value in Health, Vol. 20, No. 9 (October 2017)

Code

PND8

Topic

Clinical Outcomes, Epidemiology & Public Health

Topic Subcategory

Comparative Effectiveness or Efficacy, Safety & Pharmacoepidemiology

Disease

Neurological Disorders

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