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Table 4 DMD utilization and patient characteristics: patients with MS in 2011

From: Updated cost-of-care estimates for commercially insured patients with multiple sclerosis: retrospective observational analysis of medical and pharmacy claims data

  IFN beta-1a IM IFN beta-1b Glatiramer acetate IFN beta-1a SC Natalizumab Total
All DMD users—n (%)a 1,827 (22.4) 902 (11.1) 3,261 (40.0) 1,725 (21.1) 800 (9.8) 8,145
DMD monotherapy users—n (%) 1,718 (22.0) 842 (10.8) 3,029 (38.8) 1,544 (19.8) 672 (8.6) 7,805
Characteristics of DMD monotherapy users in 2011   
  IFN beta-1a IM IFN beta-1b Glatiramer acetate IFN beta-1a SC Natalizumab P value
Demographics
Gender n (%)b,c   0.002
 Female 1,313 (76.4) 622 (73.9) 2,354 (77.7) 1,122 (72.7) 501 (74.6)  
 Male 404 (23.5) 220 (26.1) 675 (22.3) 422 (27.3) 171 (25.4)  
Mean [SD] ageb 49.6 [10.1] 47.5 [11.1] 47.3 [11.0] 45.2 [10.5] 45.6 [10.1] < 0.001
Mean [SD] DMD claimsb,d 9.21 [4.34] 9.09 [3.91] 5.95 [4.14] 9.03 [4.10] 8.92 [3.98] < 0.001
Mean [SD] days supplyb,d 274.6 [93.4] 265.3 [95.5] 186.3 [122.3] 260.9 [105.2] 241.3 [107.8] < 0.001
Mean [SD] days until DMD startb,d 45.80 [67.49] 41.57 [62.24] 76.43 [93.28] 54.17 [77.80] 49.05 [74.87] < 0.001
Disease sequelaeb   
 Abnormality of gait 104 (6.1) 80 (9.5) 247 (8.2) 133 (8.6) 107 (15.9) < 0.001
 Ataxia 20 (1.2) 26 (3.1) 68 (2.2) 37 (2.4) 29 (4.3) < 0.001
 Burning, numbness, tingling sensations 160 (9.3) 80 (9.5) 305 (10.1) 174 (11.3) 94 (14.0) 0.008
 Convulsions 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) NA
 Depression 125 (7.3) 74 (8.8) 279 (9.2) 143 (9.3) 90 (13.4) < 0.001
 Fecal incontinence 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) NA
 Fibromyalgia/myalgia and myositis 26 (1.5) 15 (1.8) 84 (2.8) 27 (1.7) 24 (3.6) 0.003
 Malaise and fatigue 209 (12.2) 137 (16.3) 493 (16.3) 261 (16.9) 187 (27.8) < 0.001
 Optic neuritis 2 (0.1) 2 (0.2) 4 (0.1) 2 (0.1) 2 (0.3) 0.809
 Spasms 33 (1.9) 23 (2.7) 73 (2.4) 39 (2.5) 37 (5.5) < 0.001
 Trigeminal neuralgia 14 (0.8) 5 (0.6) 30 (1.0) 15 (1.0) 9 (1.3) 0.621
 Urinary incontinence 31 (0.2) 21 (0.2) 61 (2.0) 23 (1.5) 29 (4.3) < 0.001
 Voice disturbance 4 (0.2) 0 (0.0) 6 (0.2) 1 (0.1) 2 (0.3) 0.449
MS charge components b Mean [SD] ($) % of Total Mean [SD] ($) % of Total Mean [SD] ($) % of Total Mean [SD] ($) % of Total Mean [SD] ($) % of Total P value
 Inpatiente 2,061 [12,706] 4.5 3,093 [15,185] 6.4 3,053 [18,590] 7.9 2,557 [14,226] 5.6 3,610 [17,308] 4.4 0.155
 Outpatiente 6,485 [18,322] 14.2 7,931 [27,432] 16.3 7,736 [19,461] 20.1 7,540 [22,866] 16.4 23,702 [26,046] 29.0 < 0.001
 Emergency roome 15 [323] 0.0 7 [97] 0.0 27 [374] 0.1 28 [364] 0.1 60 [651] 0.1 0.059
 DMD 37,209 [13,042] 81.3 37,498 [14,007] 77.3 27,694 [18,055] 71.9 35,803 [14,766] 78.0 54,255 [34,102] 66.5 < 0.001
 Total 45,770[25,674] 100.0 48,529 [33,932] 100.0 38,509 [32,570] 100.0 45,928 [30,434] 100.0 81,627 [42,528] 100.0 < 0.001
  1. aCounts (%) sum to more than the total DMD user cohort size (100%) because patients could be treated with more than 1 DMD during the year.
  2. bCalculated for patients using a single DMD during 2011 (n = 7,805).
  3. cTable and chi-square test exclude 1 patient treated with IFN beta-1a with missing gender information.
  4. dIncludes both medical and pharmacy claims. Days until DMD start represents the number of days from January 1, 2011, until the date of the first DMD claim. For medical claims, days supply was estimated based on the expected dosing schedule for each DMD (count of injections × interval based on dosing schedule).
  5. eCharges for medical claims with an MS diagnosis (ICD-9-CM = 340.xx in any diagnosis field or a DRG code for MS).
  6. DMD = disease-modifying drug; IFN = interferon; IM = intramuscular; MS = multiple sclerosis; SC = subcutaneous; SD = standard deviation.
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