Description of the Characteristics of Multiple Sclerosis Patients in the Region of Valencia (Spain) Who Requested Treatment with Disease-Modifying Drugs during the 2005-2014 Decade.

BACKGROUND: More than 3,000 multiple sclerosis (MS) patients were treated with disease-modifying drugs (DMDs) in the Region of Valencia during 2005-2014. We aimed at describing the demographic and clinical characteristics of MS patients who requested treatment with DMDs, variations in their use, and the factors associated with change to second-line therapies during this decade. METHODS: A retrospective cohort study with information from Subcomité Especializado de Medicamentos de Alto Impacto Sanitario y/o Económico registers. A statistical analysis was run in 2 phases: descriptive analysis of the sample using classical statistical methods, and of DMD trend by a chi-square test for linear trends; analytic analysis to examine the factors associated with change to second-line treatment (logistic regression model). RESULTS: We selected 2,205 patients (mean age 32.12, SD 9.64; 70% females, and 86.6% remising-remitting MS (RRMS)); 1,012 patients were attended to in highly specialized MS units (45.8%); 525 in monographic units (23.8%); and 668 in general units (30.2%). DMD prescriptions increased, and glatiramer acetate was more widespread at the end of the period (35.4%). CONCLUSION: Variability in access to different treatments was slight. The younger the patient, the higher the risk of first-line RRMS treatment failing in female gender and first treatment with interferon.

[Utilization of growth hormone in Valencia Region, Spain, during the period 2003-2007]. / Utilización de hormona de crecimiento en la Comunidad Valenciana durante el período 2003-2007.

BACKGROUND: The main goal is to analyze the evolution of the consumption of growth hormone (Somatropin) at the Valencia region (Spain). The research focuses on the period comprising 2003-2007 and aims at assessing the impact of the change in the conditions of dispensation of the hormone (May 2005) as well as of the approval of a new indication in 2004. We have also studied the number of treated patients and expenses saved in public money due to the denial of certain treatments. METHODS: The patient data have been obtained from a proprietary database owned by the regions government, this database contains information about the requests for treatment and the consumption of growth hormone has been obtained from database Gaia and drug consumption in the hospital. The data are expressed in terms of number of treated patients, consumed milligrams and cost. RESULTS: The number of patients treated with growth hormone has increased 50% (from 346 patients in 2003 to 520 in 2007). The denial of requests for treatment has made it possible to save 3.912.253 capital JE, Ukrainian. The cost per mg of growth hormone has decreased from 27.35 capital JE, Ukrainian in 2003, when the hormone was dispensed in local pharmacy stores, to 22.34 capital JE, Ukrainian in 2007, when it was dispensed at hospitals pharmacies. The change in the conditions in which the drug is dispensed has led to a reduction of 18.3% considering current costs. CONCLUSIONS: The number of treated patients has increased a 50% from 2003 to 2007. In this period of time has been approved a new indication. The cost/mg has been reduced a 18,3 % due to the change in the conditions of dispensation. The Advisory Committee has contributed to the utilization of growth hormone according to rational drug use criteria.