METHODS: A retrospective longitudinal study was conducted using the MarketScan(R) Commercial Claims and Encounters and Medicare Supplemental Database. Patients had to have at least one ICD-9 for MS (340.XX) in 2009 and one in 2008, be older than 18 years, and have continuous enrolment in the years 2009--2010. HRA was defined as having >=2 relapses in 2009. Multivariate analyses compared all-cause and MS-specific emergency room (ER) visits, hospitalizations, and all-cause costs, excluding disease modifying therapy (DMT) costs, in 2010 between patients with and without HRA, controlling for baseline characteristics. A subgroup analysis using treatment exposure was also performed.
RESULTS: 19,219 patients were included: 5.3% (n=1,017) had >=2 relapses in 2009. Patients with HRA were more likely to have all-cause and MS-specific resource utilization than patients without HRA. Mean total all-cause non DMT costs were $12,057 higher for the HRA group. In the subgroup analysis, HRA treatment-naive patients were more likely to start treatment, and HRA treatment-experienced patients were more likely to discontinue or switch index DMT (P<0.01)
CONCLUSIONS: Patients with >=2 relapses annually have higher resource utilization and costs. The difference in cost was over twice as large in treatment-naive patients versus treatment-experienced patients. HRA was also associated with an increased likelihood of starting DMT treatment (treatment-naive patients), and switching or discontinuing DMT therapy (treatment-experienced patients).
As we have said relapses are not good for your health, this study also shows that they increase costs. This is surely obvious