Trends in Medicare Part D Spending on Disease-Modifying Therapies for Multiple Sclerosis and Autoimmune Neurological Disorders

A group of researchers examined trends in Medicare Part D spending on disease-modifying therapies (DMTs) for multiple sclerosis (MS) and autoimmune neurological-related disorders (ANRD) from 2013 to 2021. The analysis included claims prescribed by clinicians with the taxonomy “neurology,” “MS,” or “ANRD.” Researchers also analyzed the percentage change under the following 3 categories: oral, injectable, and infusion drugs. Over the 8-year period, 79 DMTs were analyzed, encompassing 18 injectable, 31 oral, and 30 infusible therapies, resulting in 18.3 million claims and total payments of $11.2 billion.

The results revealed a significant increase in both the number of DMTs available and the associated costs. The number of DMT claims rose by 24.3%, from approximately 15.8 million in 2013 to more than 20.2 million in 2021, while total spending surged by 112.2%. Notably, the share of claims for infusible DMTs decreased from 11.9% to 6.2%, but spending on these therapies nearly tripled, making up 39.7% of total DMT payments. Overall, Medicare Part D expenditures for MS and ANRD therapies outpaced health care inflation during this period.

The findings underscore the need for legislative action, especially in light of the Inflation Reduction Act of 2022, which aims to lower prescription drug costs for Medicare, according to the authors. The study suggests that the rising costs of MS and ANRD DMTs, particularly infusible therapies, warrant consideration for future cost-reduction strategies within the Centers for Medicare and Medicaid Services budget.

Reference

Wong KH, Marini E, Francis T, et al. Nine-year trends in payments for disease modifying therapies in multiple sclerosis and autoimmune neurological related disorders in Medicare Part D. Presented at: the American Academy of Neurology 2024 Annual Meeting; October 25-27, 2024; Paradise, NV; Abstract S31.001.