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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Multiple Sclerosis and Neuroimmunology
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1458458

High socioeconomic impact on prescription behavior despite unrestricted access to disease-modifying therapies in people with multiple sclerosis

Provisionally accepted
Sara Samadzadeh Sara Samadzadeh 1Joachim Havla Joachim Havla 2Klaudia Lepka Klaudia Lepka 1Ralph Brinks Ralph Brinks 3Sven G. Meuth Sven G. Meuth 1Luisa Klotz Luisa Klotz 4Philipp Albrecht Philipp Albrecht 1*
  • 1 Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
  • 2 LMU Munich University Hospital, Munich, Bavaria, Germany
  • 3 Faculty of Health, Witten/Herdecke University, Witten-Herdecke, North Rhine-Westphalia, Germany
  • 4 University of Münster, Münster, North Rhine-Westphalia, Germany

The final, formatted version of the article will be published soon.

    Background: Economic and health care restraints strongly impact on drug prescription for chronic diseases. We aimed to identify potential factors for prescription behavior in chronic disease. Multiple sclerosis was chosen as a model disease due to its chronic character, incidence, and high socioeconomic impact. Methods: Germany was used as a model country as the health-care system is devoid of economic and drug availability restraints. German statutory health insurance data were analyzed retrospectively. The impact of number of university hospitals and neurologists as well as the gross domestic product (GDP) as potential factors on prescriptions of platform and high-efficacy disease-modifying therapies (DMTs) was analyzed.Results: Prescription of platform DMTs increased over time in almost all federal states with varying degree of increase. Univariate regression analysis showed that the prescription volume of platform DMTs positively correlated with the number of university hospitals and neurologists, as well as the GDP per federal state. Stepwise forward regression analysis including all potential factors indicated a statistically significant model for platform DMT (R 2 =0.55; 95%-CI [0.28, 0.82]; p=0.001) revealing GDP as the main contributor. This was confirmed in the independent analysis.This study illustrates that even without overt drug prescription inequity, access to medication is not evenly distributed and depends on economic strength and regional medical care density.

    Keywords: Multiple sclerosis1, prescription behavior2, socioeconomics3, medical care density4, regional differences5

    Received: 02 Jul 2024; Accepted: 29 Jul 2024.

    Copyright: © 2024 Samadzadeh, Havla, Lepka, Brinks, Meuth, Klotz and Albrecht. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Philipp Albrecht, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.