Among the 400 patient medical records abstracted, 84, 132, and 184 patients were in the low-, medium-, and high-cost groups, respectively. Patients included in the analysis had a mean age of 41 at diagnosis, and 70% were female. Nearly all (97%) of the patients had brain MRI results documented in their medical records. Of the 389 patients with MRI results, 31.7% of the low-, 53.6% of the medium-, and 35.2% of the high-cost patients had active brain lesions. Common symptoms reported were numbness (63%), fatigue (59%), and pain (59%). Relapsing-remitting disease was documented in 14% of the low-, 40% of the medium-, and 33% of the high-cost patients. Approximately 50% of the patients had gait impairment, ranging from 38% of the low-, 44% of the medium-, and 64% of the high-cost patients. Other brain MRI results not related to T2 imaging, active lesions, demyelination, black holes, and brain atrophy were seen to a greater extent among high-cost patients.
In addition, high-cost patients were more likely to use antidepressants (31.5%), corticosteroids (43.5%), narcotics (38.6%), and stimulants (6.5%). High-cost patients also were more likely to have electrocardiogram (36.4%) and spinal tap (20.1%) procedures.
Lead author Dr. Eisenberg is affiliated with HealthCore, a company headquartered in Wilmington, Delaware.
—Glenn S. Williams