PND91 PREDICTORS OF NON-ADHERENCE AMONG PATIENTS WITH MULTIPLE SCLEROSIS NEWLY INITIATING ONCE- OR TWICE-DAILY ORAL DISEASE-MODIFYING DRUGS

Abstract

To evaluate factors associated with non-adherence among patients with multiple sclerosis (MS) newly initiating once- or twice-daily oral disease-modifying drugs (DMDs). This IQVIA™ RWD Adjudicated Claims - US data study used data from 7/1/2012–12/31/2017. Eligibility criteria were: ≥2 MS diagnoses (ICD-9 CM code 340.xx and ICD-10 CM code G35) between 7/1/2013–12/31/2016, ≥1 once-/twice-daily oral-DMD claim between 7/1/2013–12/31/2016 (index), continuous 1-year eligibility with commercial insurance pre- and post-index, no baseline oral DMD, and age 18-64 years. Logistic regression evaluated predictors of non-adherence (proportion of days covered [PDC] <0.8) to index DMD expressed as odds ratios (OR) [95% confidence intervals (CI)]. A total of 7,689 patients met eligibility criteria. Mean (SD) age was 45.2 (10.2) years and 75.9% were female. Using PDC <0.8, 3,036 (39.5%) were non-adherent over one year. Demographic characteristics associated with a lower likelihood of adherence included younger age (18-24 years vs.: 25-34 OR 0.60 [95% CI 0.45-0.80]; 35-44 OR 0.58 [95% CI 0.44-0.76]; 45-54 OR 0.56 [95% CI 0.42-0.73]; 55-64 OR 0.49 [95% CI 0.37-0.65]) or female sex (OR 0.83 [95% CI 0.74-0.93]). Patients with depression (OR 0.78 [95% CI 0.70-0.88]) or migraine (OR 0.79 [95% CI 0.69-0.91]) were less likely to adhere. More frequent dosing (twice- vs. once-daily; OR 0.80 [95% CI 0.73-0.88]), 90-day pre-index relapse requiring an emergency room visit (OR 0.65 [95% CI 0.54-0.80]), absence of 90-day pre-index magnetic resonance imaging (MRI) test (OR 0.83 [95% CI 0.75-0.91]), or absence of 90-day pre-index neurology visit (OR 0.88 [95% CI 0.78-0.99]) were also associated with lower likelihood of adherence. Findings from this study showed that one-year non-adherence in patients with MS newly-initiating once- or twice-daily oral DMDs was common (39.5%), and that opportunities for reducing risk of non-adherence may include improved continuity of care, i.e. neurology visits and MRI, and less frequent dosing regimens.