Document Detail


Cost-sharing and initiation of disease-modifying therapy for multiple sclerosis.
MedLine Citation:
PMID:  22928761     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objectives: To assess the effects of patient costsharing on initiation of disease-modifying therapies (DMTs) in multiple sclerosis (MS). Study Design: Retrospective claims database study of privately insured patients newly diagnosed with MS between 2004 and 2008 from 33 large employers. Methods: We assessed the effects of plan-level cost-sharing on DMT initiation during a 2-year follow-up period after diagnosis. Incident cases were identified by 2 or more claims with ICD-9 codes for MS within a year, subsequent to a year with no such claims. Covariates for adjustment included age, gender, relationship to primary beneficiary, comorbid conditions, and calendar year, as well as unobserved factors that did not vary within plans over time. Results: Out of a sample of 3460 patients meeting criteria for inclusion, only 17% initiated a DMT within 2 years of diagnosis. An increase in the cost-sharing rate from zero to the 95th percentile (17.8%) was predicted to decrease initiation within 2 years of diagnosis by 2.9 percentage points, or 12.7% (P = .019). Conclusions: High cost-sharing is associated with delayed initiation of effective MS therapies.
Authors:
John Romley; Dana Goldman; Michael Eber; Homa Dastani; Edward Kim; Swetha Raparla
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of managed care     Volume:  18     ISSN:  1936-2692     ISO Abbreviation:  Am J Manag Care     Publication Date:  2012  
Date Detail:
Created Date:  2012-08-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9613960     Medline TA:  Am J Manag Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  460-4     Citation Subset:  H    
Affiliation:
Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, 3335 S Figueroa St, Unit A, Los Angeles, CA 90089-7273. E-mail: romley@ sppd.usc.edu.
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