title: Working-age persons with multiple sclerosis and access to disease-modifying medications.
abstract: US residents can face serious financial barriers to obtaining prescription medications, including disease-modifying medications for multiple sclerosis (MS). We conducted 30-min telephone surveys with 983 persons with MS nationwide, 21-64 years old, to explore how financial and health insurance concerns affect access to services including MS drugs. Almost everyone (96.3%) had some health insurance. Multivariable logistic regression analyses accounted for demographic, disease and insurance characteristics. Only 10.8% of those <40 years old had never received disease-modifying medications, compared with 41.1% of persons aged 60-64. Among the uninsured, 36.8% reported having never taken these medications, compared with 21.2% of persons with health insurance. Adjusted odds ratio (95% CI) of using these drugs in prior 12 months among the uninsured (compared with insured persons) was 0.28 (0.08, 0.95). Just over 16% of persons with public health plans reported that their insurer initially denied coverage for MS medication. When asked about MS medications in general, 22.3% reported having not filled prescriptions, skipping doses or splitting pills because of cost concerns; 22.4% worried ;a lot' about getting MS medications when they needed them. Substantial fractions of persons with MS confront financial and health plan-related barriers to obtaining MS drugs.
authors: Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, the Charles A. Dana Research Institute, and the Harvard-Thorndike Laboratory, Boston, MA 02115, USA. liezzoni@partners.org
authors: L I
authors: LI
authors: Iezzoni
authors: L H
authors: LH
authors: Ngo
authors: R P
authors: RP
authors: Kinkel
mesh_terms: D000328:Adult; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007348:Insurance, Health / Q000706:statistics & numerical data*; D017054:Insurance, Medigap / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D017057:Medically Uninsured / Q000706:statistics & numerical data; D006278:Medicare / Q000706:statistics & numerical data; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000191:economics; D015999:Multivariate Analysis; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D007155:Immunologic Factors