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      Therapeutic Interferon Interchange in Relapsing Multiple Sclerosis Lowers Health Care and Pharmacy Expenditures with Comparable Safety

      research-article
      , PharmD , PharmD , PharmD , PhD, MS
      The Permanente Journal
      The Permanente Journal

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          Abstract

          Introduction

          For patients with a less-active (fewer relapses or complete recovery from relapses, less radiologic burden of disease, or no or limited disease-related disability) relapsing form of multiple sclerosis (MS), interferon (IFN) beta-1b subcutaneous is similar in efficacy to IFN beta-1a intramuscular and subcutaneous. The purpose of this study was to assess the impact of patient interchange from an IFN beta-1a to IFN beta-1b.

          Methods

          This was a retrospective, pre-post study of adult patients with relapsing MS who underwent interchange from an IFN beta-1a to IFN beta-1b between April 15, 2014, and April 30, 2015. Health care financial and utilization outcomes between the 6 months before and after interchange were compared, and safety outcomes after interchange were assessed.

          Results

          A total of 36 primarily white, middle-age, and female patients underwent interchange. Monthly total health care and pharmacy expenditures decreased by approximately 40% and 44%, respectively, from pre-to-post interchange (p < 0.001). Health care utilization was unchanged (p < 0.05). Seven (43.8%) patients underwent interchange back to IFN beta-1a intramuscular. No patients underwent interchange back to IFN beta-1a subcutaneous. The most common adverse effect reported after interchange was injection-site reaction.

          Conclusion

          Health care expenditures decreased and adverse effects were limited among patients with MS who underwent an interchange from an IFN beta-1a to IFN beta-1b. These findings suggest that a therapeutic interchange between IFNs for patients with less-active MS disease is well tolerated. Further research is needed to determine the impact of such an interchange on disease progression.

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          Author and article information

          Journal
          Perm J
          Perm J
          prjl
          The Permanente Journal
          The Permanente Journal
          1552-5767
          1552-5775
          2018
          30 August 2018
          : 22
          : 18-046
          Affiliations
          Clinical Pharmacy Specialist in Neurology for Kaiser Permanente Colorado, a Clinical Instructor at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences in Aurora and Clinical Affiliate Faculty at Regis University School of Pharmacy in Denver ( nicole.m.hahn@ 123456kp.org )
          Clinical Pharmacy Specialist in the Anticoagulation and Anemia Service for Kaiser Permanente Colorado in Denver ( kelsey.e.palmer@ 123456kp.org )
          Clinical Pharmacy Specialist in Neurology for Kaiser Permanente Colorado, a Clinical Assistant Professor at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences in Aurora and Clinical Affiliate Faculty at Regis University School of Pharmacy in Denver ( shilpa.klocke@ 123456kp.org )
          Clinical Pharmacy Research Scientist in the Pharmacy Department for Kaiser Permanente Colorado and a Clinical Instructor at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences in Aurora ( tom.delate@ 123456kp.org )
          Article
          PMC6131095 PMC6131095 6131095 18-046
          10.7812/TPP/18-046
          6131095
          30201091
          7594e4f4-682b-428e-87f2-524a85f52d92
          © 2018 The Permanente Journal
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          Original Research & Contributions

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