Persistence, Discontinuations, and Refill Adherence

A real-world study evaluating VUMERITY persistence, discontinuation rates, and adherence1

Study design

Limitations and disclosures

  • The AcariaHealth SPP lacks detailed baseline data required for comparative analyses vs other DMTs. Also, the exact MS subtype cannot be discerned from this database
  • While PDC measures timely refilling and whether the patient has access to the drug, it cannot definitively determine if a patient is taking each dose of medication as directed
  • Short follow-up period (median duration of VUMERITY treatment was 7.6 months)

aAll patient information was anonymized, and patient confidentiality was maintained through compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations. Information on patients’ prior DMT use was based on pharmacy records.1

bAny unidentified AE that led to discontinuation within 90 days of starting VUMERITY was counted as a GI AE, to avoid underestimation of discontinuation rate.1

cPDC is widely accepted as a valid measure of patient adherence and is the preferred method for assessing adherence by the Pharmacy Quality Alliance for use in the Medicare plan Star Ratings.1,2

VUMERITY provided high rates of persistence, low discontinuation rates due to GI AEs, and high rates of adherence in a real-world study1

88.6% of patients remained persistent on VUMERITY over 8 months

Persistence to VUMERITY in the overall study population

  • Dashed lines represent 95% confidence intervals.1

3.8% discontinuation rate due to GI AEs with VUMERITY in the overall study population1

Discontinuation rate and discontinuation due to GI adverse events

Overall (N =160)

Characteristic

n (%)

95% CI

Discontinued VUMERITY

18 (11.3)

6.7–17.8

Discontinued VUMERITY due to GI AE

6d (3.8)

1.4–8.2

Discontinuation rate and discontinuation due to GI adverse events

DMF-to-VUMERITY
subgroup (n=26)

Characteristic

n (%)

95% CI

Discontinued VUMERITY

2 (7.7)

0.9–27.8

Discontinued VUMERITY due to GI AE

1e,f (3.8)

0.1–21.4

Discontinuation rate and discontinuation due to GI adverse events

Overall (N =160)

DMF-to-VUMERITY
subgroup (n=26)

Characteristic

n (%) 95% CI

n (%) 95% CI

Discontinued VUMERITY

18 (11.3) 6.7–17.8

2 (7.7) 0.9–27.8

Discontinued VUMERITY due to GI AE

6d (3.8) 1.4–8.2

1e,f (3.8) 0.1–21.4

  • Only 1 of the 26 patients (3.8%) who switched from DMF to VUMERITY discontinued VUMERITY due to GI AEsf
  • 86.7% (13/15) of patients who switched from DMF to VUMERITY for a known reason did so due to GI tolerability issuesf

>90% of the patients who switched to VUMERITY from DMF stayed on VUMERITY at the time of the study1

dIn the overall population, the other non–GI-related reasons for DRF treatment discontinuation included “other AE” (n=11) and “Physician Decision – Pursuing Alternate Therapy” (n=1).1

eThe 1 patient in the DMF-to-DRF subgroup who discontinued DRF due to GI AEs had also discontinued prior DMF due to GI AE at 60 days after DMF initiation. After switching to DRF, the patient was treated for 30 days prior to discontinuing.1

fIn the DMF-to-DRF subgroup, the other non–GI-related reasons for DRF treatment discontinuation included “other AE” (n=1).1

 

Patients on VUMERITY demonstrated high rates of adherence by PDC in the overall population1

PDC is the preferred method for assessing adherence by the Pharmacy Quality Alliance for use in the Medicare plan Star Ratings1

The study population consisted of real-world VUMERITY patients

80.6% of patients were women, and the median age was 51 years

Patient demographics and baseline characteristics (N=160)

Age, years

US regiong

Median (range)

51 (20–79)

Northeast

19 (11.9)

Age <55 years

100 (62.5)

Midwest

42 (26.3)

Age ≥55 years

60 (37.5)

South

63 (39.4)

Female

129 (80.6)

West

36 (22.5)

MS diagnosis

No prior DMTh

131 (81.9)

Confirmed by ICD-10-CM code for MS

124 (77.5)

Prior DMT

Inferred by drug therapy classification of MS

36 (22.5)

Interferon

5 (3.1)

Teriflunomide

1 (0.6)

Dimethyl fumarate

26 (16.3)

DRF treatment duration, months, median (range)

7.6 (0.1–10.4)

Patient demographics and baseline characteristics (N=160)

Age, years

Median (range)

51 (20–79)

Age <55 years

100 (62.5)

Age ≥55 years

60 (37.5)

Female

129 (80.6)

MS diagnosis

Confirmed by ICD-10-CM code for MS

124 (77.5)

Inferred by drug therapy classification of MS

36 (22.5)

Patient demographics and baseline characteristics (N=160)

US regiong

Northeast

19 (11.9)

Midwest

42 (26.3)

South

63 (39.4)

West

36 (22.5)

No prior DMTh

131 (81.9)

Prior DMT

Interferon

5 (3.1)

Teriflunomide

1 (0.6)

Dimethyl fumarate

26 (16.3)

DRF treatment duration, months, median (range)

7.6 (0.1–10.4)

All values reported as n (%) unless otherwise indicated. 

  • Diagnosis of MS was either determined by ICD-10-CM code for MS (n=124) or inferred by drug therapy classification of MS (n=36)
  • 81.9% of patients had no prior DMT, based on pharmacy records, and of patients in the overall study population, 16.3% were previously treated with DMF
  • Patients were treated for a median duration of 7.6 months

gRegional breakdown based on 2020 US Census categories for region.1

hBased on pharmacy records.1