Pandemic prescribing – what changed?

 

Use of disease-modifying therapies for MS changed substantially during the pandemic among clinicians and patients, according to two studies presented at the European Academy of Neurology (EAN) 2022 annual meeting.

An analysis of the MS database in Vienna compared DMT prescribing before (January 2017-March 2020) and during (March 2020-December 2021) the COVID-19 pandemic (Bsteh et al. EAN 2022; EPR-157).

The average number of DMT prescriptions pre-pandemic was 90.3 per year. That dropped by 54% to 41.7 prescriptions/year in the first nine months of the pandemic. Prescribing resumed in 2021, although the overall rate of DMT prescriptions during the pandemic remained low (74.8/year).

The most significant drops were seen for alemtuzumab (-64%), anti-CD20 agents (-49%), cladribine (-46%) and S1P receptor modulators (-38%). Prescriptions for natalizumab increased 24%, which likely reflected the need for a high-efficacy therapy with less of an impact on vaccine response.

Results of a survey on DMT prescribing among Canadian neurologists during the pandemic will be posted in an upcoming article on NeuroSens.

A separate study reported that MS patients were less likely to adhere to their DMT regimen during the pandemic (Baldin et al. EAN 2022; EPR-004). An administrative database analysis found that patients were 19% less likely to be treatment-adherent during the pandemic. The rate of DMT adherence was 63.4% during the pandemic. The authors speculated that restrictive public health measures may have limited access to treatment. Other factors may have included physician- or patient-initiated treatment interruptions, uncertainty about the safety of medications during the pandemic, and less encouragement from the healthcare team to remain adherent because of limited access to the MS clinic.

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