Effects of financial toxicity and socioeconomic status on MRI follow‐up time in multiple sclerosis

Abstract

AbstractBackground and PurposeMultiple sclerosis (MS) is associated with high risk for financial toxicity. Repeated magnetic resonance imaging (MRI) is standard of care but can present a financial burden for patients with MS. The purpose of this study was to identify relationships between financial factors and socioeconomic status (SES) on brain MRI follow‐up time for individuals with MS.MethodsBrain MRI scans performed during an 18‐month period were reviewed. Inclusion criteria were individuals ≥18 years old with confirmed MS diagnosis and repeated brain MRI. MRI follow‐up time (days) was calculated as the difference between subsequent scans. Demographic and clinical factors were obtained from electronic medical records. Financial factors were determined from hospital records. The area deprivation index (ADI) was used as a metric for SES. Group‐wise comparisons of MRI follow‐up time were performed as a function of demographic, clinical, and financial factors. Linear regression analyses were used to identify associations between MRI follow‐up time, financial liability, and ADI.ResultsThe final cohort included 92 individuals with MS and repeated brain MRI. MRI follow‐up times were significantly lower for individuals on Tysabri (p = .003), but no other group‐wise differences were observed. For individuals with non‐zero financial liability (n = 38), a significant positive association was observed between MRI follow‐up time and amount of financial liability for the initial scan (R = 0.486, p = .002), controlling for demographic and clinical factors.ConclusionsFinancial liability related to the cost of MRI was significantly associated with longer MRI follow‐up times in MS.