New study shows MS patients with high out-of-pocket costs not filling prescriptions

ST. PAUL, Minn. One-in-4 multiple sclerosis patients are declining to fill their prescriptions, likely due to high out-of-pocket costs, according to a new study by pharmacy benefits manager Prime Therapeutics.

The study showed that patients with an out-of-pocket expense greater than $250 were seven times more likely to decline to fill their prescriptions than patients with an out-of-pocket cost of $100 or less. This increase in the number of patients who decline to fill their MS specialty prescriptions and do not continue taking the necessary MS medications may adversely affect long-term patient care.

MS specialty medications have a typical average wholesale price of $2,500 per month's supply, or $30,000 annually.

"Specialty pharmacy costs are rising and insurers are focusing on ways to best manage costs, including increasing out-of-pocket costs for members," said Patrick Gleason, PharmD, FCCP, BCPS, lead author and director of clinical outcomes assessment at Prime. "Our research suggests members who pay high out-of-pocket costs are declining to fill their prescription. Patients who aren't taking their medications face serious medical and health complications, which could result in substantial medical or hospitalization expenses for both the patient and health insurer. Health insurers should consider member cost and the impact it has on adherence when designing specialty pharmacy benefits. "