Back to Journals » ClinicoEconomics and Outcomes Research » Volume 6

Health care-resource utilization before and after natalizumab initiation in multiple sclerosis patients in the US

Authors Bonafede M, Johnson B, Watson C

Received 11 October 2013

Accepted for publication 13 November 2013

Published 19 December 2013 Volume 2014:6 Pages 11—20


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Machaon M Bonafede,1 Barbara H Johnson,1 Crystal Watson2

1Truven Health Analytics, Cambridge, MA, USA; 2Biogen Idec, Weston, MA, USA

Objectives: To evaluate multiple sclerosis (MS)-related health care-resource utilization and costs prior to and after initiating natalizumab in the US.
Materials and methods: A retrospective administrative claims analysis was conducted using the Truven Health MarketScan Databases to identify adults diagnosed with MS who initiated natalizumab (index date) between January 1, 2007 and December 31, 2010. Patients had ≥24 months of continuous enrollment (12 months before [preperiod] and 12 months after [postperiod] the index date) and remained on natalizumab for the 12-month postperiod. Patients with and without other disease-modifying treatment (DMT) during the preperiod were examined. Patient characteristics, MS-related inpatient stays, and corticosteroid use were compared in the pre- and postperiods using paired statistical tests, where appropriate.
Results: The study comprised 1,458 patients, mean age 45.2 years (standard deviation 10.5), 74.2% female. The majority (70.3%) used a DMT during the preperiod. After initiating natalizumab, there was a significant reduction in the percentage of patients with MS-related inpatient stays (7.6% versus 2.4%, P<0.001), MS-related inpatient costs (median US $12,078 versus US $9,784, P<0.001), and length of stay (7.12 days versus 6.26 days, P=0.005). Both cohorts showed a reduction in the percentage of patients with MS-related inpatient stays and costs with greater reductions for patients without DMTs in the preperiod (–6.2% [P<0.001] and –US $1,496 [P=0.056], respectively) compared to those with a DMT in the preperiod (–4.8% and –US $1,262, respectively, P<0.001 for both). Compared to the preperiod, there were significant reductions in intravenous and oral corticosteroid use for natalizumab initiators (–60.1% and –52.9%, respectively, P<0.001 for both). These utilization reductions correspond to mean corticosteroid cost-per-patient reductions of –US $101 across all natalizumab users (P<0.001).
Conclusion: The initiation of natalizumab was associated with significant decreases in MS-related inpatient stays, and corticosteroid use with corresponding decreases in length of stay and costs among natalizumab users with and without DMTs in the prior year.

Keywords: multiple sclerosis, natalizumab, health care-resource utilization, health care costs

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]


Other articles by this author:

Medical costs associated with cardiovascular events among high-risk patients with hyperlipidemia

Bonafede MM, Johnson BH, Richhariya A, Gandra SR

ClinicoEconomics and Outcomes Research 2015, 7:337-345

Published Date: 9 June 2015

Cost of tumor necrosis factor blockers per patient with rheumatoid arthritis in a multistate Medicaid population

Bonafede M, Joseph GJ, Shah N, Princic N, Harrison DJ

ClinicoEconomics and Outcomes Research 2014, 6:381-388

Published Date: 15 September 2014

Readers of this article also read:

Emerging and future therapies for hemophilia

Carr ME, Tortella BJ

Journal of Blood Medicine 2015, 6:245-255

Published Date: 3 September 2015

A new recombinant factor VIII: from genetics to clinical use

Santagostino E

Drug Design, Development and Therapy 2014, 8:2507-2515

Published Date: 12 December 2014

Green synthesis of water-soluble nontoxic polymeric nanocomposites containing silver nanoparticles

Prozorova GF, Pozdnyakov AS, Kuznetsova NP, Korzhova SA, Emel’yanov AI, Ermakova TG, Fadeeva TV, Sosedova LM

International Journal of Nanomedicine 2014, 9:1883-1889

Published Date: 16 April 2014

Methacrylic-based nanogels for the pH-sensitive delivery of 5-Fluorouracil in the colon

Ashwanikumar N, Kumar NA, Nair SA, Kumar GS

International Journal of Nanomedicine 2012, 7:5769-5779

Published Date: 15 November 2012

Cross-linked acrylic hydrogel for the controlled delivery of hydrophobic drugs in cancer therapy

Deepa G, Thulasidasan AK, Anto RJ, Pillai JJ, Kumar GS

International Journal of Nanomedicine 2012, 7:4077-4088

Published Date: 27 July 2012

Crystallization after intravitreal ganciclovir injection

Pitipol Choopong, Nattaporn Tesavibul, Nattawut Rodanant

Clinical Ophthalmology 2010, 4:709-711

Published Date: 14 July 2010