Connectedcare for MS: Impact of managed therapy on adherence to multiple sclerosis medications

A large national retail pharmacy chain developed a patient-centric program providing enhanced levels of monitoring and care for patients taking MS Specialty Drugs as dispensed in a retail setting. MS biologics covered in the ConnectedCare for Multiple Sclerosis (CCMS) program during this analysis period included Avonex, Betaseron, Copaxone, Extavia, and Rebif. To compare adherence rates for MS biologics between managed and non-managed patients new to retail pharmacy or the CCMS program. The effect of health complications on adherence rates was also assessed. This was a retrospective analysis of MS patients new to therapy (or pharmacy chain) during the initial six months of CCMS. Patients were followed for one year. Adherence was measured using proportion of days covered (PDC). For the primary objective, propensity scores based on patients’ gender, age, presence of chronic comorbidities, and pre-study adherence to chronic medications were used to match the CCMS intervention group to a comparisons group. Sub-group analysis on health complications (chronic medication comorbidity, or assessment screenings for depression and fatigue) used Analysis of Covariance to adjust for the propensity variables when examining PDC in the presence of health complications across managed cohorts. Mean PDC was nearly 10% higher for the managed CCMS patients than for non-managed patients. Patients not managed with at least one chronic comorbidity had about an 11% lower PDC than non-managed patients without a comorbid condition, whereas, managed patients indicated little difference in relation to the presence of a comorbidity. Adherence levels were also reduced for non-managed patients reporting fatigue and depression, yet self-reports of fatigue and depression did not significantly affect adherence levels among managed patients. The provision of medication therapy management for MS patients significantly increases adherence to MS biologic medications. Among non-managed patients, adherence is even further reduced among patients with fatigue and depression.