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198 A population study of temporal changes in MS disease modifying drug management and cost
  1. Mark McCarron1,
  2. Fiona Mullan2,
  3. Carol Hinchcliff2,
  4. Ferghal McVerry1
  1. 1Altnagelvin Hospital
  2. 2WHSCT

Abstract

Background Multiple sclerosis (MS) management is changing. The prevalence of MS is increasing. We sought to investigate changes in disease modifying treatment (DMT) rates and costs in a defined population.

Methods Among a population of 296,000 (Western Health and Social Care Trust) all MS patients taking DMTs were annually recorded including sequential DMT changes over an 11-year period (2008 to 2018 inclusive). Individual patient frequency of DMT switches were recorded. Drug costs were calculated over 10 years.

Results From 2008 until 2018 there was more than a threefold increase in the number of MS patients taking a DMT (113 versus 394, Cochran-Armitage test for trend P<0.0001), representing by 2018 approximately 50% of all MS patients in this population. 216 patients switched drugs ranging from once (N=216) to 5 times (N=6 patients). Drug prices escalated sixfold from £832,351 in 2008 to £5,074,276 in 2018.

Conclusion The increasing use of DMTs suggest that most NHS neurologists should become skilled in managing MS. As DMT coverage continues to increase in the MS population, drug costs should cover the funding of neurology teams to care for DMT-treated MS patients.

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