Healthcare Costs and Resource Utilization in Patients with Multiple Sclerosis Relapses Treated with H.P. Acthar Gel
Introduction Multiple sclerosis (MS) is an autoimmune disorder with large annual costs. This study evaluated utilization and costs for the management of MS relapses with H.P. Acthar ® Gel (repository corticotropin injection; Acthar; Mallinckrodt) compared to receipt of plasmapheresis (PMP) or intrav...
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| Veröffentlicht in: | Advances in therapy 2016-08, Vol.33 (8), p.1279-1292 |
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| creator | Gold, Laura S. Suh, Kangho Schepman, Patricia B. Damal, Kavitha Hansen, Ryan N. |
| description | Introduction
Multiple sclerosis (MS) is an autoimmune disorder with large annual costs. This study evaluated utilization and costs for the management of MS relapses with H.P. Acthar
®
Gel (repository corticotropin injection; Acthar; Mallinckrodt) compared to receipt of plasmapheresis (PMP) or intravenous immunoglobulin (IVIG) among patients with MS who experienced multiple relapses.
Methods
We identified patients with MS diagnoses who had relapses treated with intravenous methylprednisolone (IVMP), the first-line treatment for MS relapse. Patients who were treated for the subsequent relapses were eligible for the study. We analyzed 12- and 24-month healthcare utilization and costs among patients who received Acthar prescriptions compared to patients who were treated with PMP/IVIG using generalized linear and logistic regression models to calculate unadjusted and adjusted means and 95% confidence intervals.
Results
For the 12-month analysis, a total of 213 patients received Acthar prescriptions and 226 were treated with PMP or IVIG. Patients who received Acthar prescriptions were similar to those who received other treatments in terms of most demographic variables. Acthar recipients had fewer hospitalizations (0.2 vs. 0.4;
P
= 0.01) and received fewer outpatient services (29 vs. 43;
P
|
| doi_str_mv | 10.1007/s12325-016-0363-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4969319</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1808604590</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-ee788f3873a72f9c81cb200b129a7157b8d5825abc0d1ae94232e19cb9883ce03</originalsourceid><addsrcrecordid>eNp9UU1v1DAUtBAV3RZ-ABfkI5csz3YS2xekagVdpCKqfkjcLMd523XlTRbbAcGvr1cpFVx6sJ6lNzNvNEPIWwZLBiA_JMYFbypgbQWiFRW8IAum2qYqj78kC5A1q7hQ34_JSUr3ABxko16RYy4F41rKBUlrtCFvnY1IV2PKidqhp1eYxik6pLfZB__HZj8O1A_0svxwKKBfPm_p1ylkvw9Ir13AOCafCjHYfcJEbyLajP0MXC8vl_TM5a2N9BzDa3K0sSHhm8d5Sm4_f7pZrauLb-dfVmcXlatrnitEqdRGKCms5BvtFHMdB-iKcytZIzvVN4o3tnPQM4u6LmEg067TSgmHIE7Jx1l3P3U77F1xHm0w--h3Nv42o_Xm_83gt-Zu_Glq3WrBdBF4_ygQxx8Tpmx2PjkMwQ44TskwBaqFutGHW2yGuhJEirh5OsPAHMoyc1mmlGUOZZkD592__p4Yf9spAD4DUlkNdxjNfallKJk9o_oA6gmhPg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1808604590</pqid></control><display><type>article</type><title>Healthcare Costs and Resource Utilization in Patients with Multiple Sclerosis Relapses Treated with H.P. Acthar Gel</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Gold, Laura S. ; Suh, Kangho ; Schepman, Patricia B. ; Damal, Kavitha ; Hansen, Ryan N.</creator><creatorcontrib>Gold, Laura S. ; Suh, Kangho ; Schepman, Patricia B. ; Damal, Kavitha ; Hansen, Ryan N.</creatorcontrib><description>Introduction
Multiple sclerosis (MS) is an autoimmune disorder with large annual costs. This study evaluated utilization and costs for the management of MS relapses with H.P. Acthar
®
Gel (repository corticotropin injection; Acthar; Mallinckrodt) compared to receipt of plasmapheresis (PMP) or intravenous immunoglobulin (IVIG) among patients with MS who experienced multiple relapses.
Methods
We identified patients with MS diagnoses who had relapses treated with intravenous methylprednisolone (IVMP), the first-line treatment for MS relapse. Patients who were treated for the subsequent relapses were eligible for the study. We analyzed 12- and 24-month healthcare utilization and costs among patients who received Acthar prescriptions compared to patients who were treated with PMP/IVIG using generalized linear and logistic regression models to calculate unadjusted and adjusted means and 95% confidence intervals.
Results
For the 12-month analysis, a total of 213 patients received Acthar prescriptions and 226 were treated with PMP or IVIG. Patients who received Acthar prescriptions were similar to those who received other treatments in terms of most demographic variables. Acthar recipients had fewer hospitalizations (0.2 vs. 0.4;
P
= 0.01) and received fewer outpatient services (29 vs. 43;
P
< 0.0001) but received more prescription medications (36 vs. 30;
P
< 0.0001) compared to recipients of PMP/IVIG. Patients who received Acthar prescriptions had lower inpatient and outpatient costs ($15,000 lower;
P
= 0.001; and $54,000 lower;
P
< 0.0001, respectively) but similar total costs. Similar results were seen in the cohort with 24 months of outcome data.
Conclusion
Acthar may be a useful treatment option compared to PMP/IVIG for patients with MS experiencing multiple relapses.
Funding
This study was funded by a grant to the University of Washington from Mallinckrodt Pharmaceuticals.</description><identifier>ISSN: 0741-238X</identifier><identifier>EISSN: 1865-8652</identifier><identifier>DOI: 10.1007/s12325-016-0363-0</identifier><identifier>PMID: 27312977</identifier><language>eng</language><publisher>Cheshire: Springer Healthcare</publisher><subject>Adolescent ; Adrenocorticotropic Hormone - administration & dosage ; Adrenocorticotropic Hormone - economics ; Adrenocorticotropic Hormone - therapeutic use ; Adult ; Cardiology ; Endocrinology ; Fees, Pharmaceutical - statistics & numerical data ; Female ; Health Expenditures - statistics & numerical data ; Health Services - economics ; Health Services - utilization ; Health technology assessment ; Hospitalization - economics ; Hospitalization - statistics & numerical data ; Humans ; Immunoglobulin G - economics ; Immunoglobulin G - therapeutic use ; Injections, Intravenous ; Injections, Subcutaneous ; Internal Medicine ; Male ; Medicine ; Medicine & Public Health ; Methylprednisolone - economics ; Methylprednisolone - therapeutic use ; Middle Aged ; Multiple Sclerosis - drug therapy ; Multiple Sclerosis - therapy ; Oncology ; Original Research ; Pharmacology/Toxicology ; Plasmapheresis - economics ; Rheumatology ; Young Adult</subject><ispartof>Advances in therapy, 2016-08, Vol.33 (8), p.1279-1292</ispartof><rights>The Author(s) 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-ee788f3873a72f9c81cb200b129a7157b8d5825abc0d1ae94232e19cb9883ce03</citedby><cites>FETCH-LOGICAL-c442t-ee788f3873a72f9c81cb200b129a7157b8d5825abc0d1ae94232e19cb9883ce03</cites><orcidid>0000-0002-4289-5231</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12325-016-0363-0$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12325-016-0363-0$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27312977$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gold, Laura S.</creatorcontrib><creatorcontrib>Suh, Kangho</creatorcontrib><creatorcontrib>Schepman, Patricia B.</creatorcontrib><creatorcontrib>Damal, Kavitha</creatorcontrib><creatorcontrib>Hansen, Ryan N.</creatorcontrib><title>Healthcare Costs and Resource Utilization in Patients with Multiple Sclerosis Relapses Treated with H.P. Acthar Gel</title><title>Advances in therapy</title><addtitle>Adv Ther</addtitle><addtitle>Adv Ther</addtitle><description>Introduction
Multiple sclerosis (MS) is an autoimmune disorder with large annual costs. This study evaluated utilization and costs for the management of MS relapses with H.P. Acthar
®
Gel (repository corticotropin injection; Acthar; Mallinckrodt) compared to receipt of plasmapheresis (PMP) or intravenous immunoglobulin (IVIG) among patients with MS who experienced multiple relapses.
Methods
We identified patients with MS diagnoses who had relapses treated with intravenous methylprednisolone (IVMP), the first-line treatment for MS relapse. Patients who were treated for the subsequent relapses were eligible for the study. We analyzed 12- and 24-month healthcare utilization and costs among patients who received Acthar prescriptions compared to patients who were treated with PMP/IVIG using generalized linear and logistic regression models to calculate unadjusted and adjusted means and 95% confidence intervals.
Results
For the 12-month analysis, a total of 213 patients received Acthar prescriptions and 226 were treated with PMP or IVIG. Patients who received Acthar prescriptions were similar to those who received other treatments in terms of most demographic variables. Acthar recipients had fewer hospitalizations (0.2 vs. 0.4;
P
= 0.01) and received fewer outpatient services (29 vs. 43;
P
< 0.0001) but received more prescription medications (36 vs. 30;
P
< 0.0001) compared to recipients of PMP/IVIG. Patients who received Acthar prescriptions had lower inpatient and outpatient costs ($15,000 lower;
P
= 0.001; and $54,000 lower;
P
< 0.0001, respectively) but similar total costs. Similar results were seen in the cohort with 24 months of outcome data.
Conclusion
Acthar may be a useful treatment option compared to PMP/IVIG for patients with MS experiencing multiple relapses.
Funding
This study was funded by a grant to the University of Washington from Mallinckrodt Pharmaceuticals.</description><subject>Adolescent</subject><subject>Adrenocorticotropic Hormone - administration & dosage</subject><subject>Adrenocorticotropic Hormone - economics</subject><subject>Adrenocorticotropic Hormone - therapeutic use</subject><subject>Adult</subject><subject>Cardiology</subject><subject>Endocrinology</subject><subject>Fees, Pharmaceutical - statistics & numerical data</subject><subject>Female</subject><subject>Health Expenditures - statistics & numerical data</subject><subject>Health Services - economics</subject><subject>Health Services - utilization</subject><subject>Health technology assessment</subject><subject>Hospitalization - economics</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Immunoglobulin G - economics</subject><subject>Immunoglobulin G - therapeutic use</subject><subject>Injections, Intravenous</subject><subject>Injections, Subcutaneous</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Methylprednisolone - economics</subject><subject>Methylprednisolone - therapeutic use</subject><subject>Middle Aged</subject><subject>Multiple Sclerosis - drug therapy</subject><subject>Multiple Sclerosis - therapy</subject><subject>Oncology</subject><subject>Original Research</subject><subject>Pharmacology/Toxicology</subject><subject>Plasmapheresis - economics</subject><subject>Rheumatology</subject><subject>Young Adult</subject><issn>0741-238X</issn><issn>1865-8652</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9UU1v1DAUtBAV3RZ-ABfkI5csz3YS2xekagVdpCKqfkjcLMd523XlTRbbAcGvr1cpFVx6sJ6lNzNvNEPIWwZLBiA_JMYFbypgbQWiFRW8IAum2qYqj78kC5A1q7hQ34_JSUr3ABxko16RYy4F41rKBUlrtCFvnY1IV2PKidqhp1eYxik6pLfZB__HZj8O1A_0svxwKKBfPm_p1ylkvw9Ir13AOCafCjHYfcJEbyLajP0MXC8vl_TM5a2N9BzDa3K0sSHhm8d5Sm4_f7pZrauLb-dfVmcXlatrnitEqdRGKCms5BvtFHMdB-iKcytZIzvVN4o3tnPQM4u6LmEg067TSgmHIE7Jx1l3P3U77F1xHm0w--h3Nv42o_Xm_83gt-Zu_Glq3WrBdBF4_ygQxx8Tpmx2PjkMwQ44TskwBaqFutGHW2yGuhJEirh5OsPAHMoyc1mmlGUOZZkD592__p4Yf9spAD4DUlkNdxjNfallKJk9o_oA6gmhPg</recordid><startdate>20160801</startdate><enddate>20160801</enddate><creator>Gold, Laura S.</creator><creator>Suh, Kangho</creator><creator>Schepman, Patricia B.</creator><creator>Damal, Kavitha</creator><creator>Hansen, Ryan N.</creator><general>Springer Healthcare</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4289-5231</orcidid></search><sort><creationdate>20160801</creationdate><title>Healthcare Costs and Resource Utilization in Patients with Multiple Sclerosis Relapses Treated with H.P. Acthar Gel</title><author>Gold, Laura S. ; Suh, Kangho ; Schepman, Patricia B. ; Damal, Kavitha ; Hansen, Ryan N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-ee788f3873a72f9c81cb200b129a7157b8d5825abc0d1ae94232e19cb9883ce03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adrenocorticotropic Hormone - administration & dosage</topic><topic>Adrenocorticotropic Hormone - economics</topic><topic>Adrenocorticotropic Hormone - therapeutic use</topic><topic>Adult</topic><topic>Cardiology</topic><topic>Endocrinology</topic><topic>Fees, Pharmaceutical - statistics & numerical data</topic><topic>Female</topic><topic>Health Expenditures - statistics & numerical data</topic><topic>Health Services - economics</topic><topic>Health Services - utilization</topic><topic>Health technology assessment</topic><topic>Hospitalization - economics</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Humans</topic><topic>Immunoglobulin G - economics</topic><topic>Immunoglobulin G - therapeutic use</topic><topic>Injections, Intravenous</topic><topic>Injections, Subcutaneous</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Methylprednisolone - economics</topic><topic>Methylprednisolone - therapeutic use</topic><topic>Middle Aged</topic><topic>Multiple Sclerosis - drug therapy</topic><topic>Multiple Sclerosis - therapy</topic><topic>Oncology</topic><topic>Original Research</topic><topic>Pharmacology/Toxicology</topic><topic>Plasmapheresis - economics</topic><topic>Rheumatology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gold, Laura S.</creatorcontrib><creatorcontrib>Suh, Kangho</creatorcontrib><creatorcontrib>Schepman, Patricia B.</creatorcontrib><creatorcontrib>Damal, Kavitha</creatorcontrib><creatorcontrib>Hansen, Ryan N.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Advances in therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gold, Laura S.</au><au>Suh, Kangho</au><au>Schepman, Patricia B.</au><au>Damal, Kavitha</au><au>Hansen, Ryan N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Healthcare Costs and Resource Utilization in Patients with Multiple Sclerosis Relapses Treated with H.P. Acthar Gel</atitle><jtitle>Advances in therapy</jtitle><stitle>Adv Ther</stitle><addtitle>Adv Ther</addtitle><date>2016-08-01</date><risdate>2016</risdate><volume>33</volume><issue>8</issue><spage>1279</spage><epage>1292</epage><pages>1279-1292</pages><issn>0741-238X</issn><eissn>1865-8652</eissn><abstract>Introduction
Multiple sclerosis (MS) is an autoimmune disorder with large annual costs. This study evaluated utilization and costs for the management of MS relapses with H.P. Acthar
®
Gel (repository corticotropin injection; Acthar; Mallinckrodt) compared to receipt of plasmapheresis (PMP) or intravenous immunoglobulin (IVIG) among patients with MS who experienced multiple relapses.
Methods
We identified patients with MS diagnoses who had relapses treated with intravenous methylprednisolone (IVMP), the first-line treatment for MS relapse. Patients who were treated for the subsequent relapses were eligible for the study. We analyzed 12- and 24-month healthcare utilization and costs among patients who received Acthar prescriptions compared to patients who were treated with PMP/IVIG using generalized linear and logistic regression models to calculate unadjusted and adjusted means and 95% confidence intervals.
Results
For the 12-month analysis, a total of 213 patients received Acthar prescriptions and 226 were treated with PMP or IVIG. Patients who received Acthar prescriptions were similar to those who received other treatments in terms of most demographic variables. Acthar recipients had fewer hospitalizations (0.2 vs. 0.4;
P
= 0.01) and received fewer outpatient services (29 vs. 43;
P
< 0.0001) but received more prescription medications (36 vs. 30;
P
< 0.0001) compared to recipients of PMP/IVIG. Patients who received Acthar prescriptions had lower inpatient and outpatient costs ($15,000 lower;
P
= 0.001; and $54,000 lower;
P
< 0.0001, respectively) but similar total costs. Similar results were seen in the cohort with 24 months of outcome data.
Conclusion
Acthar may be a useful treatment option compared to PMP/IVIG for patients with MS experiencing multiple relapses.
Funding
This study was funded by a grant to the University of Washington from Mallinckrodt Pharmaceuticals.</abstract><cop>Cheshire</cop><pub>Springer Healthcare</pub><pmid>27312977</pmid><doi>10.1007/s12325-016-0363-0</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-4289-5231</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Advances in therapy, 2016-08, Vol.33 (8), p.1279-1292 |
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| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4969319 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Adolescent Adrenocorticotropic Hormone - administration & dosage Adrenocorticotropic Hormone - economics Adrenocorticotropic Hormone - therapeutic use Adult Cardiology Endocrinology Fees, Pharmaceutical - statistics & numerical data Female Health Expenditures - statistics & numerical data Health Services - economics Health Services - utilization Health technology assessment Hospitalization - economics Hospitalization - statistics & numerical data Humans Immunoglobulin G - economics Immunoglobulin G - therapeutic use Injections, Intravenous Injections, Subcutaneous Internal Medicine Male Medicine Medicine & Public Health Methylprednisolone - economics Methylprednisolone - therapeutic use Middle Aged Multiple Sclerosis - drug therapy Multiple Sclerosis - therapy Oncology Original Research Pharmacology/Toxicology Plasmapheresis - economics Rheumatology Young Adult |
| title | Healthcare Costs and Resource Utilization in Patients with Multiple Sclerosis Relapses Treated with H.P. Acthar Gel |
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