(68) Healthcare resource utilization and costs in patients with multiple sclerosis treated with ofatumumab vs ocrelizumab

Background: : Multiple sclerosis (MS), a chronic autoimmune disease, imposes substantial economic burden for healthcare systems. Ofatumumab (OMB) and ocrelizumab (OCR) are CD20-directed monoclonal antibodies approved for treating relapsing MS. Real-world data can inform the economic impact of OMB vs OCR in a broad MS population.

Objective: : To compare MS-related healthcare resource utilization (HCRU) and associated costs between patients treated with OMB vs OCR.

Methods: : A retrospective cohort study was performed using Optum Clinformatics claims data (8/2019-7/2024) for adults with ≥1 OMB or OCR claim on or after 8/20/2020, ≥1 inpatient (IP) or ≥2 outpatient (OP) MS diagnoses ≥30 days apart, continuous enrollment for ≥12 months (M) pre- and ≥6M post-index, and persistent OMB or OCR use for ≥6M post-index. Treatment (tx)-naïve sub-cohorts included patients without MS-specific disease-modifying therapy (DMT) use 12M pre-index. Patients were matched 1:1 in overall and tx-naïve cohorts to balance demographics, disease characteristics, and resource use. MS-related HCRU and costs were defined as IP stays with primary MS diagnosis or OP/emergency department (ED) visits with MS diagnosis in any position, excluding claims with MS-related DMT codes. Rate ratios were used to compare HCRU outcomes; cost ratios were used to compare costs.

Results: : Of 2604 eligible patients (mean age: 49 years; 70% female), 751 were in OMB cohort (315 tx-naïve) and 1853 in OCR (1104 tx-naïve). Over a mean follow-up of 1.5 years, mean OP visits per patient-year (PPY) (95% CI) was 8.64 (8.19-9.11) in OMB vs 9.51 (9.03-10.01) in OCR, demonstrating 9% lower incidence for OMB (incidence rate ratio: 0.91; 95% CI: 0.84-0.98; P< 0.05). Mean OP cost PPY (95% CI) in follow-up was $3928 ($3448-$4475) in OMB vs $4807 ($4246-$5442) in OCR, equating to 18% lower OP costs for OMB (ratio: 0.82; 95% CI: 0.68-0.98; P< 0.05). Mean ED costs PPY (95% CI) in follow-up was $212 ($139-$326) in OMB vs $383 ($265-$555) in OCR, equating to 45% lower ED costs for OMB (ratio: 0.55, 95% CI: 0.31-0.98; P< 0.05). ED visits, IP visits, and costs were similar between groups. Consistent patterns were observed in the tx-naïve cohort, except ED costs.

Conclusions: : OMB had significantly lower MS-related OP visits and costs and lower ED costs compared to OCR. These findings highlight a potential economic advantage of OMB for patients, providers, and health system managers aiming to reduce facility-based utilization and costs.

Sponsorship:: Novartis Pharmaceuticals Corporation