In a recent study, Dr. Stacey Cofield, associate professor in the department of biostatistics at the University of Alabama at Birmingham, and lead author and UAB alumnus Dr. Guoqiao Wang, assistant professor at Washington University in St. Louis — in collaboration with Dr. Gary R. Cutter, professor in UAB’s department of biostatistics, and UAB alumna Dr. Amber Salter, assistant professor at Washington University in St. Louis — determined that the escalating cost of prescription drugs coupled with changes to health insurance coverage have negatively affected the ability of patients with multiple sclerosis (MS) to access treatment.
[Photo: Dr. Stacey Cofield]
To assess the link between insurance coverage and the use of disease-modifying therapy (DMT) to treat MS, the researchers examined data regarding 6,662 participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) registry pertaining to adverse insurance change in association with the type of insurance, the use of DMT, participation in cost-free or -reduced drug programs, and any insurance disputes. Results show that 6,562 (98.5 percent) of respondents had health insurance, with 1,472 (22.1 percent) indicating a negative change to their insurance within the previous year.
“Respondents with private insurance were more likely to report negative insurance change than any other insurance. Among respondents not taking DMTs, 6.1 percent cited insurance/financial concerns as the sole reason. Of respondents taking DMTs, 24.7 percent partially or completely relied on support from free/discounted drug programs. Of respondents obtaining DMTs through insurance, 3.3 percent experienced initial insurance denial of DMT use, 2.3 percent encountered insurance denial of DMT switches, and 1.6 percent skipped or split doses because of increased copay. For respondents with relapsing-remitting MS, negative insurance change increased their odds of not taking DMTs (odds ratio [OR] 1.50; 1.16–1.93), using free/discounted drug programs for DMTs (OR 1.89; 1.40–2.57), and encountering insurance challenges (OR 2.48; 1.64–3.76),” report the investigators.
They concluded that the considerable use of free or discounted drug programs among persons with MS renders any economic analysis that doesn’t take these supplements in to account potentially inexact.
“Health Insurance Affects the Use of Disease-Modifying Therapy in Multiple Sclerosis” was published online in June in the journal Neurology.