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Multiple Sclerosis
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Article

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

Lisa I Iezzoni1*, Long Ngo1, and Peter Kinkel2

1 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
2 Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA 02114, USA

* To whom correspondence should be addressed.


  Abstract

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.

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

First published on September 24, 2007, doi:10.1177/1352458507080466

Multiple Sclerosis 2008;14:112.

A more recent version of this article appeared on January 1, 2008

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