Treatment of multiple sclerosis in Germany: an analysis based on claims data of more than 30,000 patients

Background Multiple sclerosis (MS) is an incurable disease of the central nervous system. In addition to symptomatic treatment, immunomodulatory and immunosuppressant agents are used to prevent attacks and to influence the course of disease. Objective The goal of this study was to assess the drug use of MS patients in outpatient care considering gender-related and regional differences. Setting We analyzed outpatient claims data of the single largest German health insurance fund (about 9 million insurants) for the year 2010. Method Patients with MS were identified by outpatient ICD-10-GM-diagnosis code 'G35'. All age groups were included. MS-specific drug use was analysed for those patients, considering regional and gender-related differences in specific drug prescriptions. Main outcome measure Prescription rates for symptomatic treatment, relapse treatment and disease-modifying treatment. Results 31,248 patients with a diagnosis of MS were identified (0.35 % of all insurants). Their mean age was 50.4 +/- A 14.1 years, 77.7 % of them were female. 37.6 % of the included patients were treated with disease-modifying drugs, 23.4 % got prescriptions for corticosteroids, drugs of choice for relapse therapy, and 63.1 % received symptomatic treatment as defined in the study. Women with MS were prescribed significantly more non-steroidal anti-inflammatory drugs, urinary antispasmodics, antidepressants, tranquilizer and hypnotic drugs. Regional variations were also found, with highest usage of disease-modifying drugs in eastern regions of Germany. Conclusion This study gives an insight into the treatment of MS in daily practice by using the claims data of a large health insurance company. The prescription rate for disease modifying drugs was relatively low suggesting that early treatment was not routine practice. Furthermore, the results indicated that women with MS were more likely to receive treatment for psychiatric symptoms and pain.