Multiple sclerosis and disease-modifying therapies

Abstract

Over the past 18 years, treatments for multiple sclerosis (MS) called disease-modifying therapies (DMTs) have been developed. These therapies are designed to decrease the number of MS attacks, and to slow the progression of the disease. They have become a standard part of the current treatment for MS. There are different classes of the currently available DMTs: interferons, glatiramer acetate, natalizumab, and mitoxantrone. Although they are effective, these medications have significant side effects, and many are very expensive. The study by Noyes et al.1 was designed to create a new model to examine the cost-effectiveness of DMTs for relapsing-remitting MS in the United States. Researchers used data from an ongoing survey that was sent to over 2,000 people in the United States with MS. Twice a year, participants were asked questions about health care utilization. In other words, they were asked about things like how often they saw a doctor, went to the hospital, or visited the emergency department. Once a year, the same group was asked questions about income, insurance, and their work situation. The researchers examined over 800 of the surveys. Based on this, they estimated the cost of the person's health care. This included the number of hospital stays, outpatient treatments, emergency room visits, office visits, mental health visits, home health provider and home health aide visits, and laboratory and MRI studies. Since each hospital might have different charges for each procedure of tests, the authors used average Medicare reimbursements and published rates for home care to make an estimate of the overall cost of health care for MS. Lost productivity costs were also measured. The authors estimated how …