Formulary Restrictions and Relapse Episodes in Persons With Relapsing-Remitting Multiple Sclerosis

Are greater Medicare Part D formulary restrictions associated with worse health outcomes for beneficiaries with relapsing-remitting multiple sclerosis (MS)?In this cohort study of 84 870 Medicare beneficiaries with either stand-alone or Medicare Advantage prescription drug plans, broader coverage of disease-modifying therapies in the previous year was significantly associated with fewer MS relapse episodes in the current quarter.These findings suggest that beneficiaries with conditions such as relapsing-remitting MS for which disease-modifying therapies have heterogeneous treatment effects may benefit from increased formulary coverage of pharmaceutical treatments.

Corresponding Author: Geoffrey Joyce, PhD, Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, 635 Downey Way, Verna and Peter Dauterive Hall, Room 412C, Los Angeles, CA 90089 (gjoyce@usc.edu).

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