title: Economic impact of multiple sclerosis disease-modifying drugs in an employed population: direct and indirect costs.
abstract: OBJECTIVE
  The study objective is to compare the annual total medical and indirect costs of newly treated and untreated employees with multiple sclerosis (MS).
  
  
  METHODS
  A retrospective database analysis of employer medical, drug, and disability claims database (Ingenix Employer database, 1999-2005; 17 large US companies) was conducted for employees 18-64 years of age with > or =1 MS diagnosis after January 1, 2002. Employees with > or =1 MS disease-modifying drug (DMD) claim comprised the newly treated group; employees with MS but no DMD at any time comprised the untreated, comparison group. Index date was the day after the most recent claim (treated, DMD claim; untreated, MS claim) meeting the following requirements: continuous health coverage for 3 months before (baseline period) and 12 months after the index date (study period) and actively employed during baseline.
  
  
  METHODS
  Total medical costs and indirect (work loss) costs over the 1-year study period (2006 $US) were compared for DMD-treated and untreated MS employees, adjusting for baseline characteristics, including comorbidities.
  
  
  RESULTS
  During the baseline, MS employees who became treated (n = 258) were younger (40.9 vs. 44.4 years, p < 0.0001) and had a higher proportion of women (72 vs. 62%, p = 0.007) than the untreated group of MS employees who never received DMD treatment (n = 322). The 3-month baseline MS-related medical costs were higher among treated MS employees ($2520 vs. $1012, p < 0.0001). There was a nonsignificant trend toward higher baseline non-MS-related medical costs in untreated versus treated MS employees. Risk-adjusted total annual medical costs ($4393 vs. $6187, p < 0.0001) and indirect costs ($2252 vs. $3053, p < 0.0001) were significantly lower for treated MS employees than for untreated MS employees.
  
  
  CONCLUSIONS
  Initiation of MS disease-modifying drugs was associated with substantial significant medical and indirect savings for employees with MS. Study findings should be considered in the context of the study limitations (e.g., analytic focus on employees with at least 12-month follow-up; lack of clinical detail on MS severity).
authors.affiliation: Analysis Group, Inc., Boston, MA, USA.
authors.forename: Howard G
authors.initials: HG
authors.lastname: Birnbaum
authors.forename: Jasmina I
authors.initials: JI
authors.lastname: Ivanova
authors.forename: Seth
authors.initials: S
authors.lastname: Samuels
authors.forename: Matthew
authors.initials: M
authors.lastname: Davis
authors.forename: Pierre Y
authors.initials: PY
authors.lastname: Cremieux
authors.forename: Amy L
authors.initials: AL
authors.lastname: Phillips
authors.forename: Dennis
authors.initials: D
authors.lastname: Meletiche
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D017281:Cost of Illness; D006233:Persons with Disabilities; D004358:Drug Therapy / Q000191:economics*; D004651:Employment / Q000191:economics; D005260:Female; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000191:economics*; D012189:Retrospective Studies; D012727:Sex Characteristics; D014481:United States; D055815:Young Adult