Adherence, Persistence, Switching and Costs of Injectable and Oral Therapies for Multiple Sclerosis. Real Life Analysis Over 6 Years of Treatment

• Published in: Hospital pharmacy (Philadelphia) Vol. 59; no. 4; pp. 476 - 484
• Main Authors: Santoleri, Fiorenzo, Lasala, Ruggero, Berardini, Eleononora, Vernacchio, Flavia, Leo, Donato, Costantini, Alberto
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-08-2024
• Subjects: cost-effectiveness; persistence; multiple sclerosis; adherence; long-term real-life analysis; switch
• ISSN: 0018-5787; 1945-1253
• DOI: 10.1177/00185787241232615

Background: Adherence and persistence to treatment with disease-modifying therapies (DMTs) is a predictor of the efficacy of treatment. Aims: The objectives of the study were the analysis of adherence, persistence, switches, and costs of the drugs used in MS. Methods: This is a retrospective non-interventional pharmacological observational study of 610 patients diagnosed with Relapsing-Remitting Multiple Sclerosis (RRMS) under therapy between January 2007 and September 2022. Results: Adherence values were greater than 0.75 for all the drugs in considered for the study. The mean persistence value was 2.5 years on the analysis performed on the first-line treatment. Conclusion: In a therapy in which adherence is predominant, but not exclusive to therapy efficacy, persistence to the drug is synonymous with drug efficacy.
Plain Language Summary
Multiple Sclerosis (MS) is a chronic disease that often begins early in life. Like in many chronic diseases, consistent adherence to treatment is vital for the long-term effectiveness of therapies. In MS, most treatments—whether oral or parenteral—are self-administered at home, making long-term adherence crucial. Persistence in sticking with a single drug is also seen as an indicator of the treatment’s effectiveness, as longer use generally means fewer therapy changes and greater drug efficacy. This article analyzes these key pharmacy utilization metrics—adherence, persistence, and therapy switches—to directly compare the real-world effectiveness of the most commonly used MS drugs.