Patients With MS Switching to Teriflunomide: Characteristics, Utilization, and Relapses

A retrospective study of US claims data shows that patients with multiple sclerosis (MS) who switched to teriflunomide experienced reduced health care resource utilization and relapses, consistent with the efficacy reported in clinical trials. 

Switching between disease-modifying therapies (DMTs) is common in patients with MS, often due to lack of effectiveness or adverse events. However, limited data is available on the health and economic impact of this switch. 

A retrospective study using deidentified data from the US Merative™ MarketScan® claims database was conducted from January 1, 2012 to July 31, 2020. The study focused on patients aged 18 years and above who had been diagnosed with MS based on ICD-9/ICD-10 codes. These patients were required to have received at least one disease-modifying therapy prior to starting teriflunomide and have continuous enrollment for at least 12 months before and after the initiation of teriflunomide.  

The study examined various outcomes, including inpatient and emergency room claims related to MS diagnosis, health care costs, and annualized relapse rates estimated through hospitalization/outpatient claims and steroid use associated with MS diagnosis. 

The cohort that was analyzed consisted of 2016 individuals, with the majority being female (79%). The average age of the cohort was 51.4 ± 9.3 years, and the average duration of MS was 4.7 ± 2.8 years at the time of the study. Before switching to teriflunomide, 89.2% of the cohort had received treatment with one DMT.  

There was an increase in the rate of outpatient services utilization following the switch, but a significant reduction in MRI visits. The costs for MS-specific outpatient visits decreased by $371 per patient per year after the switch to teriflunomide. Additionally, the costs for MS-specific laboratory services were also reduced, despite an increase in utilization. After switching, fewer patients experienced relapses, with a decrease from 20.7% before the switch to 16.5% after the switch. The annualized relapse rate (ARR) was significantly lower after the switch as well. 

“Switching to teriflunomide from existing DMTs in patients with relapsing MS resulted in a reduction in outpatient HCRU in this analysis of US claims data,” said researchers. “The real-world effectiveness of teriflunomide was generally consistent with efficacy reported in clinical trials, showing a reduction in relapse following a switch to teriflunomide.”  

Reference  

Araujo L, Kyatham S, Bzdek KG, et al. Assessing the health economic outcomes from commercially nsured relapsing multiple sclerosis patients who switched from other disease-modifying therapies to teriflunomide, in the United States. ClinicoEconomics and Outcomes Research. 2023;15:361-373. doi:10.2147/CEOR.S401687