title: Potential health care cost savings associated with early treatment of multiple sclerosis using disease-modifying therapy.
abstract: BACKGROUND
  Clinical trials have shown that treatment with disease-modifying therapies (DMTs), such as interferon, at the time of clinically isolated syndrome can delay the onset of multiple sclerosis (MS).
  
  
  OBJECTIVE
  The objective of this study was to assess health care utilization and expenditures associated with treating patients early with DMTs rather than delaying until patients meet the full diagnostic criteria of MS.
  
  
  METHODS
  A retrospective study used insurance claims data (2000-2008) of enrolled patients before documented MS (1 inpatient or 2 outpatient claims with International Classification of Diseases, 9th Revision, Clinical Modification 340 coding). Treatment cohorts were early DMT (DMT claim before the first documented MS; N = 227) and delayed DMT (DMT started after documented MS; N = 3724). Comparisons during 1 year of follow-up were adjusted for confounding using multivariate methods.
  
  
  RESULTS
  Adjusted annual per-patient expenditures (including patient out of pocket) for early versus delayed were as follows: total ($28,280 vs $29,102; P = 0.44), excluding DMT cost ($15,214 vs $17,630; P < 0.01), and MS-related ($9365 vs $13,661; P < 0.01). Hospitalizations were 10.1% versus 16.5% (adjusted odds ratio [OR] = 0.51; 95% CI, 0.32-0.81).
  
  
  CONCLUSIONS
  Analysis indicated that early DMT treatment was associated with fewer hospitalizations than delayed treatment, and there was no statistically significant difference in annual health care expenditures. This suggests that the drug costs of early therapy were offset by savings in other medical expenditures.
authors.affiliation: Thomson Reuters, Washington, DC 20008, USA. suellen.curkendall@thomsonreuters.com
authors.forename: Suellen M
authors.initials: SM
authors.lastname: Curkendall
authors.forename: Cheng
authors.initials: C
authors.lastname: Wang
authors.forename: Barbara H
authors.initials: BH
authors.lastname: Johnson
authors.forename: Zhun
authors.initials: Z
authors.lastname: Cao
authors.forename: Ronald
authors.initials: R
authors.lastname: Preblick
authors.forename: Amelito M
authors.initials: AM
authors.lastname: Torres
authors.forename: Volker
authors.initials: V
authors.lastname: Knappertz
authors.forename: Kathleen
authors.initials: K
authors.lastname: Gondek
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D000328:Adult; D017046:Cost Savings; D005260:Female; D005500:Follow-Up Studies; D000068717:Glatiramer Acetate; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D016899:Interferon-beta / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000191:economics; D015999:Multivariate Analysis; D010455:Peptides / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000276:Adjuvants, Immunologic; D010455:Peptides; D000068717:Glatiramer Acetate; D016899:Interferon-beta