Healthcare Costs and Resource Utilization in Patients with Multiple Sclerosis Relapses Treated with H.P. Acthar Gel(®).
Multiple sclerosis (MS) is an autoimmune disorder with large annual costs. This study evaluated utilization and costs for the management of MS relapses with H.P. Acthar(®) Gel (repository corticotropin injection; Acthar; Mallinckrodt) compared to receipt of plasmapheresis (PMP) or intravenous immunoglobulin (IVIG) among patients with MS who experienced multiple relapses.



We identified patients with MS diagnoses who had relapses treated with intravenous methylprednisolone (IVMP), the first-line treatment for MS relapse. Patients who were treated for the subsequent relapses were eligible for the study. We analyzed 12- and 24-month healthcare utilization and costs among patients who received Acthar prescriptions compared to patients who were treated with PMP/IVIG using generalized linear and logistic regression models to calculate unadjusted and adjusted means and 95% confidence intervals.



For the 12-month analysis, a total of 213 patients received Acthar prescriptions and 226 were treated with PMP or IVIG. Patients who received Acthar prescriptions were similar to those who received other treatments in terms of most demographic variables. Acthar recipients had fewer hospitalizations (0.2 vs. 0.4; P = 0.01) and received fewer outpatient services (29 vs. 43; P < 0.0001) but received more prescription medications (36 vs. 30; P < 0.0001) compared to recipients of PMP/IVIG. Patients who received Acthar prescriptions had lower inpatient and outpatient costs ($15,000 lower; P = 0.001; and $54,000 lower; P < 0.0001, respectively) but similar total costs. Similar results were seen in the cohort with 24 months of outcome data.



Acthar may be a useful treatment option compared to PMP/IVIG for patients with MS experiencing multiple relapses.



This study was funded by a grant to the University of Washington from Mallinckrodt Pharmaceuticals.
Department of Pharmacy, Pharmaceutical Outcomes Research and Policy Program, University of Washington, Seattle, WA, USA. goldl@uw.edu.|Department of Radiology, Pharmaceutical Outcomes Research and Policy Program, University of Washington, Seattle, WA, USA. goldl@uw.edu.
Laura S
0000-0002-4289-5231
LS
Gold
Department of Pharmacy, Pharmaceutical Outcomes Research and Policy Program, University of Washington, Seattle, WA, USA.
Kangho
K
Suh
Regional Outcomes, Sanofi U.S., Bridgewater, NJ, USA.
Patricia B
PB
Schepman
Santen Incorporated, Emeryville, CA, USA.
Kavitha
K
Damal
Department of Pharmacy, Pharmaceutical Outcomes Research and Policy Program, University of Washington, Seattle, WA, USA.|Department of Health Services, Pharmaceutical Outcomes Research and Policy Program, University of Washington, Seattle, WA, USA.
Ryan N
RN
Hansen
D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000008:administration & dosage* / Q000191:economics* / Q000627:therapeutic use; D000328:Adult; D005252:Fees, Pharmaceutical / Q000706:statistics & numerical data; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007074:Immunoglobulin G / Q000191:economics / Q000627:therapeutic use; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D008297:Male; D008775:Methylprednisolone / Q000191:economics / Q000627:therapeutic use; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000628:therapy*; D010956:Plasmapheresis / Q000191:economics*; D055815:Young Adult
D007074:Immunoglobulin G; D000324:Adrenocorticotropic Hormone; D008775:Methylprednisolone
Costs; H.P. Acthar® gel (repository corticotropin injection); Healthcare resource utilization; Intravenous immunoglobulin; Multiple sclerosis; Neurology; Plasmapheresis