More than 50% of Patients with MS Discontinue Infusion Therapy Owing in Part to Travel Burden

Study results presented at the 2025 Annual Meeting of The Consortium of Multiple Sclerosis Centers (cMSc) demonstrated low medication adherence and persistence rates among Medicare beneficiaries with multiple sclerosis (MS) treated with infusion-based disease modifying therapies (DMTs). Most high-efficacy DMTs for MS (eg, Ocrevus [ocrelizumab; Genentech, South San Francisco, CA], Tysabri [natalizumab; Biogen, Cambridge, MA], Lemtrada [alemtuzumab; Sanofi, Bridgewater, NJ], and Briumvi [ublituximab; TG Therapeutics, New York, NY]) are administered via intravenous infusion which requires patients to travel to an infusion center. This study also showed that travel burden was associated with lower medication adherence rates in this population.

Researchers analyzed Medicare fee-for-service data to identify adults with MS who initiated an infusion-based DMT between January 2017 and September 2024, and who had at least 12 months of continuous preindex (ie, prior to date of first DMT claim) enrollment (N=20,961). Travel distance was calculated using the 5-digit zip codes of patients’ residences and infusion centers. Persistence was defined as the time from treatment initiation until discontinuation or switch, with a maximum allowed gap of 90 days. Adherence was assessed by the proportion of days covered (set at ≥0.8). Researchers used logistic regression and Cox proportional hazards regression to identify factors affecting adherence and persistence.

Key results were as follows: 

• Adherence at 24 and 36 months was 43% and 35%, respectively.
• Persistence at 24 and 36 months was 43% and 29%, respectively.
• Participants located in rural areas who had a 2-way travel distance of 61 to 120 miles had a 10% lower adherence rate than those traveling ≤60 miles (odds ratio [OR], 0.90; 95% CI, 0.84 to 0.96).
• 75% of participants did not use their nearest infusion facility and traveled an average additional 52 miles per each infusion center visit.

This study was supported by Novartis.