(192) Impact of the disability status of patients with multiple sclerosis on healthcare resource utilization and the ability to work: An analysis of the MSDS-AOK PLUS Linked Database

Background: Real-world data can be used to address a variety of questions in Multiple Sclerosis (MS) research. The availability of data parameters among individual sources, including disease registries, electronic medical records, and administrative claims data, varies. The linkage of multiple databases offers a unique opportunity, expanding real-world evidence capabilities in MS.

Objectives: The objective of this study is to explore the relationship between the patient’s disability, determined by Expanded Disability Status Scale (EDSS) score, and healthcare resource utilization (HCRU).

Methods: The German AOK PLUS sickness fund and the Center for Neuroscience at the University of Dresden cooperated with IPAM to generate a linked database, combining administrative claims data from the AOK PLUS with medical records from the Multiple Sclerosis Management System 3D (MSDS3D). We created a subset of patients with EDSS documentation from medical records in 2022 and linked HCRU outcomes in 2022 from the claims dataset. The relationship between disability status and HCRU was evaluated using Poisson regression analysis. Main patient characteristics (age, sex, and Charlson Comorbidity Index) were included as covariates. No or mild disability (reference group) was defined by an EDSS score below 3. Comparator groups were patients with EDSS 3–5 (moderate disability) and patients with EDSS >5 (severe disability).

Results: In total, 544 patients with EDSS documentation in 2022 were selected from the linked dataset. The mean age of the analysis sample was 45.7 years, and 73.7% were female. The mean EDSS score was 3.08, with 297 patients having a score of < 3 (54.6%) and 154 (28.3%)/93(17.1%) having a score of 3-5/>5. Patients with no or mild disability had significantly fewer MS-related hospitalizations per patient-year compared to moderately and severely disabled patients (0.06 versus 0.15 [p-value 0.007] and 0.33 [p-value < 0.001]). Furthermore, patients with no/mild disability visited also significantly less often an outpatient neurologist (0.31 versus 0.65 [p-value < 0.001] and 0.82 [p-value < 0.001]) and other specialists due to MS (1.52 versus 2.33 [p-value < 0.001] and 3.26 [p-value < 0.001]). They also had fewer drug prescriptions per patient-year (8.61 versus 12.23 [p-value < 0.001] and 15.95 [p-value < 0.001]). For a subset of patients that are not retired or insured family members (380 patients), the MS-related days absent from work per patient-year were examined: 22.81 days (EDSS < 3) versus 37.82 days (EDSS 3-5; p-value < 0.001) and versus 52.30 days (EDSS >5; p-value < 0.001).

Conclusions: A worsening MS-related disability status has a considerable economic impact and is significantly related to a loss of work productivity.