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Introduction <p>Multiple sclerosis (MS) is a demyelinating disease of the central nervous system, often associated with significant disability. As treatment options increase, comparative effectiveness data for disease-modifying therapies (DMTs) are essential. This study evaluated treatment switching, healthcare resource utilization, and cost outcomes among US patients with MS (PwMS) treated with cladribine tablets (CladT) vs. fingolimod (FTY), dimethyl fumarate (DMF), and teriflunomide (TER) during a 4-year follow-up period.</p> Methods <p>This retrospective study used claims data from the Komodo Healthcare Map (4/1/2018–3/31/2024). Adult PwMS with ≥ 1 claim for CladT, FTY, DMF, and TER were included. Index date was the first claim date for the respective DMT. Continuous enrollment for 12&#xa0;months pre-index and 48&#xa0;months post-index was required. Cohorts were balanced using propensity score weighting and 4-year outcomes were assessed using generalized linear and Cox proportional hazards models.</p> Results <p>Overall, 3038 PwMS were included: CladT (<i>n</i> = 140), FTY (<i>n</i> = 454), DMF (<i>n</i> = 1465), and TER (<i>n</i> = 979). In the weighted cohorts, mean age was 48&#xa0;years, and&#xa0;74–77% were female. Treatment switching during a 4-year follow-up period was lower for CladT (11%), vs. FTY (42%), DMF (57%), and TER (42%) cohorts. CladT showed lower all-cause medical costs per patient per year (PPPY): $13,377 vs. FTY (adjusted mean difference [AMD] $10,073; 95% confidence interval (CI) $5006–15,148), DMF (AMD $12,013; 95%&#xa0;CI $7490–16,706), and TER (AMD $9917; 95%&#xa0;CI $6558–13,997) cohorts. All-cause total costs PPPY were lower with CladT ($53,007) vs. FTY (AMD $14,140; 95%&#xa0;CI $7181–22,021) and TER (AMD $6652; 95%&#xa0;CI $567–12,395) cohorts, but similar to DMF cohort (AMD $4472; 95%&#xa0;CI − $2011, $11,111).</p> Conclusion <p>PwMS treated with CladT had significantly fewer treatment switches and lower all-cause medical costs vs. FTY, DMF, and TER. Total healthcare costs were lower vs. FTY and TER but similar to DMF.</p>

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Real-World, Long-Term Outcomes with Cladribine Tablets Versus Other Oral Treatments Among Patients with Multiple Sclerosis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月19日

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  • Ajay S. Gupta,
  • Joanna P. MacEwan,
  • Jeffrey Anderson,
  • Xin Zhao,
  • Sonia Kim,
  • Andy Surinach,
  • Yu Hong,
  • Amy L. Phillips,
  • Xiaoxue Chen

摘要

Introduction

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system, often associated with significant disability. As treatment options increase, comparative effectiveness data for disease-modifying therapies (DMTs) are essential. This study evaluated treatment switching, healthcare resource utilization, and cost outcomes among US patients with MS (PwMS) treated with cladribine tablets (CladT) vs. fingolimod (FTY), dimethyl fumarate (DMF), and teriflunomide (TER) during a 4-year follow-up period.

Methods

This retrospective study used claims data from the Komodo Healthcare Map (4/1/2018–3/31/2024). Adult PwMS with ≥ 1 claim for CladT, FTY, DMF, and TER were included. Index date was the first claim date for the respective DMT. Continuous enrollment for 12 months pre-index and 48 months post-index was required. Cohorts were balanced using propensity score weighting and 4-year outcomes were assessed using generalized linear and Cox proportional hazards models.

Results

Overall, 3038 PwMS were included: CladT (n = 140), FTY (n = 454), DMF (n = 1465), and TER (n = 979). In the weighted cohorts, mean age was 48 years, and 74–77% were female. Treatment switching during a 4-year follow-up period was lower for CladT (11%), vs. FTY (42%), DMF (57%), and TER (42%) cohorts. CladT showed lower all-cause medical costs per patient per year (PPPY): $13,377 vs. FTY (adjusted mean difference [AMD] $10,073; 95% confidence interval (CI) $5006–15,148), DMF (AMD $12,013; 95% CI $7490–16,706), and TER (AMD $9917; 95% CI $6558–13,997) cohorts. All-cause total costs PPPY were lower with CladT ($53,007) vs. FTY (AMD $14,140; 95% CI $7181–22,021) and TER (AMD $6652; 95% CI $567–12,395) cohorts, but similar to DMF cohort (AMD $4472; 95% CI − $2011, $11,111).

Conclusion

PwMS treated with CladT had significantly fewer treatment switches and lower all-cause medical costs vs. FTY, DMF, and TER. Total healthcare costs were lower vs. FTY and TER but similar to DMF.