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Eur J Hosp Pharm. 2019 Sep;26(5):280-284. doi: 10.1136/ejhpharm-2018-001499. Epub 2018 Apr 28.

High-dose oral methylprednisolone for the treatment of multiple sclerosis relapses: cost-minimisation analysis and patient's satisfaction.

Author information

1
Department of Pharmacy, Hospital General Universitario de Guadalajara, Guadalajara, Spain.
2
Ciencias Biomédicas, Universidad de Alcala de Henares Facultad de Farmacia, Alcala de Henares, Spain.
3
Department of Neurology, Hospital General Universitario de Guadalajara, Guadalajara, Spain.
4
Research Unit, Hospital General Universitario de Guadalajara, Guadalajara, Spain.

Abstract

Objective:

To study the use of high-dose oral methylprednisolone compounded formulation and intravenous methylprednisolone for the treatment of multiple sclerosis relapses. To compare both routes of methylprednisolone administration related to cost and patient's satisfaction with the treatment.

Methods:

A retrospective cohort observational study was performed from January 2012 to December 2016. All multiple sclerosis relapses treated with high-dose oral methylprednisolone compounded formulation or intravenous methylprednisolone were studied. Patient's acceptance grade of the treatment was analysed with a survey based on the Treatment Satisfaction Questionnaire for Medication. A cost-minimisation analysis using real world data from our hospital was performed to compare the high-dose oral methylprednisolone formulation and intravenous administration.

Results:

92 patients were included (88% had recurrent remitting multiple sclerosis). Median Expanded Disability Status Scale score was 2 (IRC: 1-3.5). 162 relapses were treated: 77 with intravenous methylprednisolone and 85 with high-dose oral methylprednisolone formulation. The most frequent prescriptions were 1000 mg intravenous methylprednisolone and 1250 mg oral methylprednisolone during 4 days. Recovery from relapse was achieved in 91% of patients in the intravenous group and 93% in the oral group. The survey revealed that 79% of patients preferred the oral route because of convenience (P<0.001) and global satisfaction (P<0.04). Real world data demonstrated savings of €61 708 (91%) using the high-dose oral methylprednisolone formulation during the study period.

Conclusions:

High-dose oral methylprednisolone compounded formulation was a cost-effective alternative compared with methylprednisolone intravenous administration. Moreover, patients with multiple sclerosis preferred the oral compounded formulation for the treatment of relapses.

KEYWORDS:

cost-minimization analysis; multiple sclerosis; patient’s satisfaction; relapse; treatment

PMID:
31656616
PMCID:
PMC6788278
[Available on 2020-09-01]
DOI:
10.1136/ejhpharm-2018-001499

Conflict of interest statement

Competing interests: None declared.

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