108  UK multiple sclerosis service and DMT audit of 70 centres: variation in DMT prescribing. Issue 6 (27th May 2022)

• Record Type: Journal Article
• Authors: Rog, David; Mathews, Joela; Hobart, Jeremy
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 93:Issue 6(2022)
• Page Start: A134
• Page End: A134
• Publication Date: 2022-05-27
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2022-ABN.433
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Introduction: The UK MS service audit builds upon GIRFT's recommendation for disease-specific data. Here, we address MS disease modifying treatment (DMT) prescribing. Aim: To document MS Teams' DMT prescribing. Methods: We asked all MS services to share their MS DMT prescribing for the 2018/2019 financial year. We computed: the proportion of people living with MS (PLwMS) on DMTs; drugs prescribed, ratios of higher- to-lower potency drugs, costs to the NHS. Results: To date, 49/70 (70%) services have shared data (none declined our request). They treated >21, 000 people with DMTs. The proportion of PLwMS on DMTs varied 5.5-fold (range=14.6% to 79.4%; mean=39%). Most services (34/49; 69%) had unrestricted prescribing. These services varied 5-fold (9% to 50%) in the proportion of people prescribed monoclonal antibodies (alemtuzumab, natalizumab, ocrelizumab). The total annual spend from 49 services exceeded £261 million (extrapolated to £373million from 70 services). Mean DMT spend/patient was £12, 096 but varied 3.6-fold (£7, 116 to £25, 833). NHSE quote the total annual increase in DMT spend was 10% in 2019/2020. Conclusions: DMT prescribing variations are expected, but important, if associated with differing outcomes. We recommend the substantial DMT spend and its increase, demands UK investment to: maximise processes (full data reporting to prescribers) and outcome measurement (including dashboard of longi- tudinal and peer-benchmark prescribing practice, eg induction vs escalation approaches and sequenc- ing) to provide optimal real world evidence to guide prescribing. Acknowledgements: Neurology Academy [e-mail] 79