Understanding Patient Preferences Can Promote Adherence in MS Patients, Study Says

Patients with multiple sclerosis (MS) must practice treatment adherence in order to reduce the rates of relapses, hospitalizations, and to decrease the rate of disease progression.

Thus, patient preferences are important to take into account and are increasingly important as alternatives to traditional injection therapies are developed to address adherence issues.

“Medication adherence rates in patients with MS have been shown to be affected by multiple factors, including physical or cognitive difficulties, drug costs, patient preferences determined by the perceived lack of treatment efficacy, treatment-related adverse events, injection anxiety, and burden of administration frequency,” the authors wrote.

A study published by the Journal of Managed Care & Specialty Pharmacy investigates MS patient preferences of noneconomic and economic attributes of current disease-modifying therapies (DMTs). The research utilized an online, cross-sectional conjoint analysis survey to quantify the preferred attributes of the therapies into an overall score.

The survey identified and calculated a score for 6 attributes:

1. Overall efficacy based on the autoimmune disease progression stabilization
2. Acute increase in disease activity (flare-up)
3. The rates of respiratory tract infections
4. The rate of serious respiratory tract infections that lead to hospitalization
5. Medication use
6. Patient monthly out-of-pocket medication expenses

A total of 123 subjects were included in the study and the researchers found monthly out-of-pocket costs was the most significant factor (38.4%) affecting decisions for patients with MS. The overall importance for each remaining attribute was 21.5% for route and frequency of administration, 15.9% for risk of hospitalization by infection, 11.9% for risk of respiratory tract infection, 7.4% for risk of flare-ups, and 5% for disease progression stabilization.

These results exemplify the significance of monthly out-of-pocket costs associated with DMT treatments. This factor demonstrates the need for patients to be informed and aware of the value of the therapy in order to for the safety and efficacy to hold a greater weight than the cost.

“Patients need to be aware of the increased convenience or safety of a therapy before they perceive that the additional costs are worthwhile,” the authors concluded. “Providers should discuss these issues with patients at the point of care. Plan benefit design managers and other stakeholders need to continue taking action to ensure that DMT treatments are affordable to guarantee adherence and therefore positive clinical outcomes.”