High socioeconomic impact on prescription behavior despite unrestricted access to disease-modifying therapies in people with multiple sclerosis

S Samadzadeh; J Havla; K Lepka; R Brinks; S G Meuth; L Klotz; P Albrecht

doi:10.3389/fimmu.2024.1458458

High socioeconomic impact on prescription behavior despite unrestricted access to disease-modifying therapies in people with multiple sclerosis

S Samadzadeh
, J Havla
, K Lepka
, R Brinks
, S G Meuth
, L Klotz
, P Albrecht^*

^*Corresponding author for this work

Medicine (NSR)

Research output: Contribution to journal › Article › Research › peer-review

Abstract

BACKGROUND: Economic and health care restraints strongly impact on drug prescription for chronic diseases. We aimed to identify potential factors for prescription behavior in chronic disease. Multiple sclerosis was chosen as a model disease due to its chronic character, incidence, and high socioeconomic impact.

METHODS: Germany was used as a model country as the health-care system is devoid of economic and drug availability restraints. German statutory health insurance data were analyzed retrospectively. The impact of number of university hospitals and neurologists as well as the gross domestic product (GDP) as potential factors on prescriptions of platform and high-efficacy disease-modifying therapies (DMTs) was analyzed.

RESULTS: Prescription of platform DMTs increased over time in almost all federal states with varying degree of increase. Univariate regression analysis showed that the prescription volume of platform DMTs positively correlated with the number of university hospitals and neurologists, as well as the GDP per federal state. Stepwise forward regression analysis including all potential factors indicated a statistically significant model for platform DMT (R2 = 0.55; 95%-CI [0.28, 0.82]; p=0.001) revealing GDP as the main contributor. This was confirmed in the independent analysis.

CONCLUSION: This study illustrates that even without overt drug prescription inequity, access to medication is not evenly distributed and depends on economic strength and regional medical care density.

Original language	English
Article number	1458458
Number of pages	8
Journal	Frontiers in Immunology
Volume	15
DOIs	https://doi.org/10.3389/fimmu.2024.1458458
Publication status	Published - 15 Aug 2024

Funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. Funding for the IMS data as well as support for medical writing was provided by Novartis based on a research grant to LK, JH and PA.

Funders
Novartis

Keywords

Humans
Multiple Sclerosis/drug therapy
Germany/epidemiology
Socioeconomic Factors
Retrospective Studies
Health Services Accessibility
Drug Prescriptions/statistics & numerical data
Female
Male
Multiple sclerosis
Prescription behavior
Medical care density
Socioeconomics
Regional differences

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10.3389/fimmu.2024.1458458

Cite this

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title = "High socioeconomic impact on prescription behavior despite unrestricted access to disease-modifying therapies in people with multiple sclerosis",

abstract = "BACKGROUND: Economic and health care restraints strongly impact on drug prescription for chronic diseases. We aimed to identify potential factors for prescription behavior in chronic disease. Multiple sclerosis was chosen as a model disease due to its chronic character, incidence, and high socioeconomic impact.METHODS: Germany was used as a model country as the health-care system is devoid of economic and drug availability restraints. German statutory health insurance data were analyzed retrospectively. The impact of number of university hospitals and neurologists as well as the gross domestic product (GDP) as potential factors on prescriptions of platform and high-efficacy disease-modifying therapies (DMTs) was analyzed.RESULTS: Prescription of platform DMTs increased over time in almost all federal states with varying degree of increase. Univariate regression analysis showed that the prescription volume of platform DMTs positively correlated with the number of university hospitals and neurologists, as well as the GDP per federal state. Stepwise forward regression analysis including all potential factors indicated a statistically significant model for platform DMT (R2 = 0.55; 95\%-CI [0.28, 0.82]; p=0.001) revealing GDP as the main contributor. This was confirmed in the independent analysis.CONCLUSION: This study illustrates that even without overt drug prescription inequity, access to medication is not evenly distributed and depends on economic strength and regional medical care density.",

keywords = "Humans, Multiple Sclerosis/drug therapy, Germany/epidemiology, Socioeconomic Factors, Retrospective Studies, Health Services Accessibility, Drug Prescriptions/statistics \& numerical data, Female, Male, Multiple sclerosis, Prescription behavior, Medical care density, Socioeconomics, Regional differences",

author = "S Samadzadeh and J Havla and K Lepka and R Brinks and Meuth, \{S G\} and L Klotz and P Albrecht",

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AU - Samadzadeh, S

AU - Havla, J

AU - Lepka, K

AU - Brinks, R

AU - Meuth, S G

AU - Klotz, L

AU - Albrecht, P

PY - 2024/8/15

Y1 - 2024/8/15

N2 - BACKGROUND: Economic and health care restraints strongly impact on drug prescription for chronic diseases. We aimed to identify potential factors for prescription behavior in chronic disease. Multiple sclerosis was chosen as a model disease due to its chronic character, incidence, and high socioeconomic impact.METHODS: Germany was used as a model country as the health-care system is devoid of economic and drug availability restraints. German statutory health insurance data were analyzed retrospectively. The impact of number of university hospitals and neurologists as well as the gross domestic product (GDP) as potential factors on prescriptions of platform and high-efficacy disease-modifying therapies (DMTs) was analyzed.RESULTS: Prescription of platform DMTs increased over time in almost all federal states with varying degree of increase. Univariate regression analysis showed that the prescription volume of platform DMTs positively correlated with the number of university hospitals and neurologists, as well as the GDP per federal state. Stepwise forward regression analysis including all potential factors indicated a statistically significant model for platform DMT (R2 = 0.55; 95%-CI [0.28, 0.82]; p=0.001) revealing GDP as the main contributor. This was confirmed in the independent analysis.CONCLUSION: This study illustrates that even without overt drug prescription inequity, access to medication is not evenly distributed and depends on economic strength and regional medical care density.

AB - BACKGROUND: Economic and health care restraints strongly impact on drug prescription for chronic diseases. We aimed to identify potential factors for prescription behavior in chronic disease. Multiple sclerosis was chosen as a model disease due to its chronic character, incidence, and high socioeconomic impact.METHODS: Germany was used as a model country as the health-care system is devoid of economic and drug availability restraints. German statutory health insurance data were analyzed retrospectively. The impact of number of university hospitals and neurologists as well as the gross domestic product (GDP) as potential factors on prescriptions of platform and high-efficacy disease-modifying therapies (DMTs) was analyzed.RESULTS: Prescription of platform DMTs increased over time in almost all federal states with varying degree of increase. Univariate regression analysis showed that the prescription volume of platform DMTs positively correlated with the number of university hospitals and neurologists, as well as the GDP per federal state. Stepwise forward regression analysis including all potential factors indicated a statistically significant model for platform DMT (R2 = 0.55; 95%-CI [0.28, 0.82]; p=0.001) revealing GDP as the main contributor. This was confirmed in the independent analysis.CONCLUSION: This study illustrates that even without overt drug prescription inequity, access to medication is not evenly distributed and depends on economic strength and regional medical care density.

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KW - Health Services Accessibility

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KW - Female

KW - Male

KW - Multiple sclerosis

KW - Prescription behavior

KW - Medical care density

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JO - Frontiers in Immunology

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M1 - 1458458

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High socioeconomic impact on prescription behavior despite unrestricted access to disease-modifying therapies in people with multiple sclerosis

Abstract

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Keywords

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