Comparison Of Compliance And Discontinuation Rates Among Ms Patients Treated With Fingol Imod And Other Disease-Modifying Therapies: A Canadian Retrospective Claims Analysis

Pharmacological management of relapsing-remitting multiple sclerosis (RRMS) includes the use of oral, injectable, or infusible Disease Modifying Therapies (DMTs). Achieving therapeutic goals in MS requires strict adherence to medication administration schedule. To assess compliance and discontinuation rates with DMTs in Canadian patients with RRMS. This non-interventional, retrospective analysis was based on private claims patient cohorts accessed through IMS Rx Dynamics®. Patients had at least one prescription filled for each DMT (oral: fingolimod, dimethyl fumarate (DMF), teriflunomide; injectable (BRACE): interferon beta-1a, interferon beta-1b, glatiramer acetate; infusible: natalizumab). Patients were compliant if the medication possession ratio (MPR) was ≥80%. Discontinuation rates were calculated based on patients who stopped therapy or who were switched to another DMT. Compliance and discontinuation rates were collected at 6-month intervals with compliance cohorts from August 2011 to December 2014 (rolling 36 months total) and discontinuation cohorts from September 2011 to January 2015. Compliance data was collected for 10315 patients (fingolimod, n=1524; DMF, n=1828; teriflunomide, n=456; natalizumab, n=604; BRACE, n=5903). Compliance rate across Canada was higher for fingolimod (78%) compared to other DMTs, including natalizumab (72%), DMF (70%), and BRACE (56%). In Quebec, fingolimod had a compliance rate of 80%, higher than DMF (68%) and BRACE (65%). Patients on fingolimod had the lowest discontinuation rate across Canada (22%), compared to natalizumab (30%) and BRACE (47%). In Quebec, DMF had a higher discontinuation rate (29%) than other orals (fingolimod, 20%; teriflunomide, 23%) and natalizumab (25%). In a Canadian real-world setting, the compliance rate with fingolimod was higher than for other DMTs while the discontinuation rate with fingolimod was lower compared to other DMTs. These findings may facilitate MS management strategies which may lead to improved clinical and economic outcomes. Findings based in part on data licensed from IMS Health Canada Inc. All Rights Reserved.