There has been a significant reduction in number of people with multiple sclerosis who have to give up work prematurely, and the benefit is being attributed to the introduction of more effective disease modifying treatments (DMTs).
A survey of 1240 people with MS conducted by researchers at the Menzies Institute for Medical Research, University of Tasmania, found that for those with relapsing remitting MS (RRMS), the risk of leaving employment before the age of 65 due to MS was 33% lower in the period 2010–2016 as compared to before 2010, when DMTs were not widely used.
The reduction in risk of leaving the workforce became stronger over time, being 43% and 51% lower when using 2012 and 2013 as time cutpoints.
This changing pattern of employment retention coincided with the increased usage of higher efficacy DMTs in participants with RRMS, increasing from 0% in 2005 to 8.4% in 2010 to 48% in 2015.
However, there was no reduction in rates of leaving employment for people with primary progressive and secondary progressive MS, with hazard ratios above or close to 1.00 for all cut-points. The authors noted that the efficacy of DMTs is lower in these populations than in RRMS, and subsidised access to DMTs has only been available for people with RRMS in Australia.
People with a higher risk of leaving their employment due to MS included males, people with progressive MS, those with a lower education level and those older at diagnosis, “suggesting that they may need additional assistance in order to stay longer in the labour force,” the study authors including Dr Jing Chen and Dr Ingrid van der Mei wrote in the Multiple Sclerosis Journal.
They acknowledged that earlier diagnosis and treatment due to changes in diagnostic criteria may also have contributed to better health and employment outcomes in RRMS.
“The widespread development of multidisciplinary MS clinics and expansion of the roles of MS nurse specialists could also have improved overall care of people with MS in Australia. This may have impacted most on those with RRMS who tend to be seen more frequently due to the requirements of monitoring for DMT usage,” they wrote.
Nevertheless, they concluded that the findings suggested a benefit for high efficacy DMT on employment outcomes for people with RRMS, and these benefits should be considered in the overall cost effectiveness evaluations of such therapies.