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This version was published on January 1, 2008
Multiple Sclerosis, Vol. 14, No. 1, 112-122 (2008)
DOI: 10.1177/1352458507080466

Working-age persons with multiple sclerosis and access to disease-modifying medications

L.I. Iezzoni

Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, the Charles A. Dana Research Institute, and the Harvard-Thorndike Laboratory, Boston, MA 02115, USA, liezzoni{at}partners.org

L.H. Ngo

Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, the Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory, Boston, MA 02115, USA

R.P. Kinkel

Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA 02114, USA

US residents can face serious financial barriers to obtaining prescription medications, including disease-modifying medications for multiple sclerosis (MS). We conducted 30-min telephone surveys with 983 persons with MS nationwide, 21—64 years old, to explore how financial and health insurance concerns affect access to services including MS drugs. Almost everyone (96.3%) had some health insurance. Multivariable logistic regression analyses accounted for demographic, disease and insurance characteristics. Only 10.8% of those <40 years old had never received disease-modifying medications, compared with 41.1% of persons aged 60—64. Among the uninsured, 36.8% reported having never taken these medications, compared with 21.2% of persons with health insurance. Adjusted odds ratio (95% CI) of using these drugs in prior 12 months among the uninsured (compared with insured persons) was 0.28 (0.08, 0.95). Just over 16% of persons with public health plans reported that their insurer initially denied coverage for MS medication. When asked about MS medications in general, 22.3% reported having not filled prescriptions, skipping doses or splitting pills because of cost concerns; 22.4% worried `a lot' about getting MS medications when they needed them. Substantial fractions of persons with MS confront financial and health plan-related barriers to obtaining MS drugs. Multiple Sclerosis 2008; 14: 112—122. http://msj.sagepub.com

Key Words: access • disease-modifying medications • health insurance • multiple sclerosis


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