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Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
2015 (English)Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
Abstract [en]

Introduction: Multiple sclerosis (MS) is an autoimmune disease that causes the demyelination and subsequent degeneration of axons. Approximately 18 000 individuals suffer from MS in Sweden.

Aim: The aim was to describe drug utilization patterns of new oral MS drugs and to investigate what factors (e.g., patient characteristics, reimbursement restrictions) might explain the observed utilization patterns.

Methods: This was an observational population-based study of all MS drugs users residing in Stockholm County. Data analyses were conducted at the aggregate level and at the individual level. Patients initiated on any MS drug were selected from the VAL database between 1 November 2011 and 31 October 2014. Characteristics of patients were compared using ANOVA and chi-square test.

Results: Since the introduction of new oral drugs the use of Avonex started decreasing while the use of Gilenya and Tecfidera increased proportionally. The use of Betaferon, Copaxone and Rebif was also declining. Aubagio and Extavia were virtually not used at all. The sex (p = 0.3687) and age distribution (p= 0.1961) did not differ between patients treated with injectable therapies and those who started on Gilenya or Tecfidera. All patients were seen by a specialist, but differences were observed in the use of other healthcare resources, namely admission to hospitals (p = 0.0085) and visits to the primary care practice (p = 0.0424). No differences were found in the prevalence of pain and comedications use between the users of injectable therapies, Gilenya and Tecfidera (p = 0.4998).

Conclusions: Avonex was commonly used in MS patients. Gilenya and Tecfidera were rapidly adopted since their introduction. The use of Aubagio had been limited due to its risk-benefit profile and reimbursement restriction. Analyses of characteristics of patients who initiated on injectable MS drugs, Gilenya and Tecfidera indicate that these populations were similar in terms of age, sex distribution, comorbidities and comedications used. 

Place, publisher, year, edition, pages
2015. , 27 p.
National Category
URN: urn:nbn:se:uu:diva-242170OAI: oai:DiVA.org:uu-242170DiVA: diva2:782652
Available from: 2015-01-23 Created: 2015-01-22 Last updated: 2015-01-23Bibliographically approved

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