Author Of 1 Presentation
P0501 - The impact of socioeconomic status on the access to disease modifying therapy in people with multiple sclerosis. (ID 1507)
Abstract
Background
Disease modifying therapies (DMTs) are unaffordable to many people with multiple sclerosis (MS) in privately funded health care systems. Evidence, to date, to support whether socioeconomic inequality in accessing DMTs for MS exists in publicly funded healthcare systems is equivocal.
Objectives
To examine whether access to DMTs for MS depends on the socioeconomic status (SES) using a geographically diverse population through the UK MS Register
Methods
The UK MS register, which was launched in 2011, aims to capture real world data about living with MS in the UK and collaborates with many hospitals across the country. We included all patients of working age with disease duration less than 6 years who were living in England and were diagnosed with relapsing remitting MS after the age of 29, between 2010 and 2017. SES was measured by their levels of education, financial resources and English index of multiple deprivation (IMD). IMD were divided into quintiles for the analysis. Any patients who did not provide information about their SES were excluded.
Results
A total of 1060 patients registered in the UK MS registry with mean age of 44 (standard error (SE), 0.25) years and mean disease duration of 2.34 (SE, 0.05) years were eligible. 819/1060 (77%) patients were female and 388/1060 (37%) patients received DMTs. We observed that people with MS who had postgraduate education had significantly better access to DMTs compared to secondary school attendees even when the analysis was adjusted for age, disease duration and financial resources. Access to DMTs did not depend upon whether the patients were employed, homemakers, receiving disability benefits, unemployed or retired. However, patients who worked in skilled and trade professions were less likely to receive DMTs compared to those who worked as managers, directors and senior officials with an odds ratio (OR) of 0.46 (95% confidence interval (CI), 0.22-0.96) even when the analysis was adjusted for education levels, age and disease duration. People who were less deprived were more likely to be treated with DMTs; OR for receiving DMT in the 5th IMD quintile (least deprived) was 1.96 (95% CI, 1.23-3.11) compared to 1st IMD quintile (most deprived), when adjusted for age and disease duration. The R2 value of these models showed that 3-5% of variation in accessing DMTs were dependent on these SES indices indicating that the influence of SES was small in our publicly funded national health service.
Conclusions
We found that the likelihood of receiving DMTs depend on the level of education, occupation and IMD suggesting that SES may influence the access to DMTs, in an English population.
Presenter Of 1 Presentation
P0501 - The impact of socioeconomic status on the access to disease modifying therapy in people with multiple sclerosis. (ID 1507)
Abstract
Background
Disease modifying therapies (DMTs) are unaffordable to many people with multiple sclerosis (MS) in privately funded health care systems. Evidence, to date, to support whether socioeconomic inequality in accessing DMTs for MS exists in publicly funded healthcare systems is equivocal.
Objectives
To examine whether access to DMTs for MS depends on the socioeconomic status (SES) using a geographically diverse population through the UK MS Register
Methods
The UK MS register, which was launched in 2011, aims to capture real world data about living with MS in the UK and collaborates with many hospitals across the country. We included all patients of working age with disease duration less than 6 years who were living in England and were diagnosed with relapsing remitting MS after the age of 29, between 2010 and 2017. SES was measured by their levels of education, financial resources and English index of multiple deprivation (IMD). IMD were divided into quintiles for the analysis. Any patients who did not provide information about their SES were excluded.
Results
A total of 1060 patients registered in the UK MS registry with mean age of 44 (standard error (SE), 0.25) years and mean disease duration of 2.34 (SE, 0.05) years were eligible. 819/1060 (77%) patients were female and 388/1060 (37%) patients received DMTs. We observed that people with MS who had postgraduate education had significantly better access to DMTs compared to secondary school attendees even when the analysis was adjusted for age, disease duration and financial resources. Access to DMTs did not depend upon whether the patients were employed, homemakers, receiving disability benefits, unemployed or retired. However, patients who worked in skilled and trade professions were less likely to receive DMTs compared to those who worked as managers, directors and senior officials with an odds ratio (OR) of 0.46 (95% confidence interval (CI), 0.22-0.96) even when the analysis was adjusted for education levels, age and disease duration. People who were less deprived were more likely to be treated with DMTs; OR for receiving DMT in the 5th IMD quintile (least deprived) was 1.96 (95% CI, 1.23-3.11) compared to 1st IMD quintile (most deprived), when adjusted for age and disease duration. The R2 value of these models showed that 3-5% of variation in accessing DMTs were dependent on these SES indices indicating that the influence of SES was small in our publicly funded national health service.
Conclusions
We found that the likelihood of receiving DMTs depend on the level of education, occupation and IMD suggesting that SES may influence the access to DMTs, in an English population.