Rates of Early Treatment for US Veterans With Multiple Sclerosis

Background: Early treatment of patients with multiple sclerosis (MS) may prevent neurological damage and reduce the risk of disability. However, little is known about the timing of treatment initiation following diagnosis and long-term outcomes in the general population of the Department of Veterans Affairs (VA) benefits-eligible patients. Objective: Our objective was to characterize treatment for MS patients in the VA at various time points following diagnosis date. Methods: In our historical database cohort study of US veterans, we calculated the proportion of MS patients from 1999 through 2010 with at least one prescription for a medication used to treat the condition at 6, 12, 24, 36, 48, 60, and 72 months following the index date. We also stratified the treatments given into 3 categories based on their role within the course of the disease: disease modifying, relapse, and symptom. Finally, we performed our calculations separately by MS subtype: relapsing-remitting, secondary-progressive, primary-progressive, and progressive-relapsing. Results: A total of 6803 patients were included in the analysis. Only 27.4% of MS patients received a prescription for MS medication within the first 6 months after diagnosis. The most common treatments were interferon β-1a, glatiramer, amantadine, and prednisone, with disease-modifying agents being more than twice as frequently prescribed as medications for relapse or symptoms. Patients with relapsing-remitting MS were the most likely to be treated, followed by progressive-relapsing MS. Conclusions: Our results suggest that treatment rates are low in VA MS patients in the 6 years following their first diagnosis of MS.