Treatment patterns and health care resource utilization associated with dalfampridine extended release in multiple sclerosis: a retrospective claims database analysis.
BACKGROUND
Although previous studies have demonstrated the clinical benefits of dalfampridine extended release (D-ER) tablets in patients with multiple sclerosis (MS), there are limited real-world data on D-ER utilization and associated outcomes in patients with MS.


OBJECTIVE
The objective of this study was to evaluate treatment patterns, budget impact, and health care resource utilization (HRU) associated with D-ER use in a real-world setting.


METHODS
A retrospective claims database analysis was conducted using the HealthCore Integrated Research Database(SM). Adherence (measured by medication possession ratio, or [MPR]) and persistence (measured by days between initial D-ER claim and discontinuation or end of follow-up) were evaluated over 1-year follow-up. Budget impact was calculated as cost per member per month (PMPM) over the available follow-up period. D-ER and control cohorts were propensity-score matched on baseline demographics, comorbidities, and MS-related resource utilization to compare walking-impairment-related HRU over follow-up.


RESULTS
Of the 2,138 MS patients identified, 1,200 were not treated with D-ER (control) and 938 were treated with D-ER. Patients were aged 51 years on average and 74% female. Approximately 82.6% of D-ER patients were adherent (MPR >80%). The estimated budget impact range of D-ER was $0.014-$0.026 PMPM. Propensity-score-matched D-ER and controls yielded 479 patients in each cohort. Postmatching comparison showed that the D-ER cohort was associated with fewer physician (21.5% vs 62.4%, P<0.0001) and other outpatient visits (22.8% vs 51.4%, P<0.0001) over the 12-month follow-up. Changes in HRU from follow-up to baseline were lower in the D-ER cohort for metrics including walking-impairment-related hospitalizations and emergency department visits.


CONCLUSIONS
The majority of D-ER patients were adherent to treatment. D-ER utilization was associated with fewer walking-impairment-related physician and outpatient visits, with lower HRU increase over time. The budget impact of D-ER was low.
Acorda Therapeutics Inc., Ardsley, New York, NY, USA.
Amy
A
Guo
HealthCore Inc., Wilmington, DE, USA.
Michael
M
Grabner
HealthCore Inc., Wilmington, DE, USA.
Swetha Rao
SR
Palli
Acorda Therapeutics Inc., Ardsley, New York, NY, USA.
Jessica
J
Elder
Acorda Therapeutics Inc., Ardsley, New York, NY, USA.
Matthew
M
Sidovar
Acorda Therapeutics Inc., Ardsley, New York, NY, USA.
Peter
P
Aupperle
Corinne Goldsmith Dickinson Center for MS, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Stephen
S
Krieger
budget impact; costs; health outcomes; real-world; walking impairment