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Socio-economic status influences access to second-line disease modifying treatment in Relapsing Remitting Multiple Sclerosis patients

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  • Floriane Calocer
  • Olivier Dejardin
  • Karine Droulon
  • Guy Launoy
  • Gilles Defer

Abstract

Objective: In MS, Socio-Economic status (SES) may influence healthcare and access to disease-modifying treatments (DMTs). Optimising delays to switch patients to a second-line DMT may hamper disease progression most effectively and achieve long term disease control. The objective of this study is to identify the influence of SES on the delay between first and second line DMT in RRMS patients, in Western-Normandy, France. Methods: The association between SES and the delay to access a second-line DMT were studied using data from the MS registry of Western-Normandy including 733 patients with a diagnosis of RRMS during the period in question [1982–2011]. We used the European Deprivation Index (EDI), a score with a rank level inversely related to SES. We performed multivariate adjusted Cox models for studying EDI effect on the delay between first and second line DMT. Results: No significant influence of SES was observed on delay to access a second-line DMT if first-line DMT exposure time was less than 5 years. After 5 years from initiation of first-line treatment the risk of accessing a second-line DMT is 3 times higher for patients with lower deprivation indices (1st quintile of EDI) ([HR] 3.14 95%CI [1.72–5.72], p-value

Suggested Citation

  • Floriane Calocer & Olivier Dejardin & Karine Droulon & Guy Launoy & Gilles Defer, 2018. "Socio-economic status influences access to second-line disease modifying treatment in Relapsing Remitting Multiple Sclerosis patients," PLOS ONE, Public Library of Science, vol. 13(2), pages 1-12, February.
    • Handle: RePEc:plo:pone00:0191646
    DOI: 10.1371/journal.pone.0191646
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    References listed on IDEAS

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    1. Krieger, N., 1992. "Overcoming the absence of socioeconomic data in medical records: Validation and application of a census-based methodology," American Journal of Public Health, American Public Health Association, vol. 82(5), pages 703-710.
    2. Trudy Owens & Nikos Evangelou & David Whynes, 2013. "Rationing and deprivation: disease-modifying therapies for multiple sclerosis in the United Kingdom," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 315-321, April.
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