Patients with MS who use the most effective disease-modifying drugs are two to three times more likely to report more time in employment and improvements in work attendance and productivity than patients who use less effective treatments.
The findings are consistent with other data showing the employment rate of Australians with MS has improved in recent years – perhaps because of the availability of more potent therapies.
In the latest sub-study from the Australian MS Longitudinal Study, data from 874 patients who used disease-modifying therapies in the last five years was matched with work-related outcomes.
Patients were typically women with a mean age of 50 and relapsing remitting MS of more than 11 years duration.
Eleven publicly subsidised drugs were grouped into three categories based on the recognised efficacy from clinical trials.
Overall, 70-80% of participants reported that disease-modifying therapy did not change their employment outcomes – with up to 20% reporting an increase across three employment outcomes and less than 10% reporting a decrease in outcomes.
However users of higher efficacy (category 3) drugs including fingolimod, natalizumab, alemtuzumab and mitoxantrone were 2.84 times more likely to report an increased amount of work, 3.14 times more likely to report increased work attendance and 2.5 times more likely to report increased work productivity than users of category 1 (classical injectable) drugs such as beta-interferons and glatiramer acetate.
“Fingolimod and natalizumab consistently exerted significantly greater effects on the perceived improvements in the three employment outcomes with natalizumab showing the largest effect size,” the study said.
“Our research found that people using the most effective drugs were two to three times more likely to report improvements in the amount of work they were able to do, in work attendance and work productivity,” the study authors said.
“This can be used to support the case that these drugs have an important, practical and positive impact on work life for people with MS. These findings are very exciting as it is the first time employment outcomes have been examined in relation to these drugs.”
A related article found 56% of workers with MS experienced productivity loss related to their disease – contributing to an estimated total cost of about $66 million Australia wide.
The study determined that MS-related presenteeism accounts for three times more work productivity loss than absenteeism.
Productivity was almost completely determined by severity of symptom clusters such as fatigue and cognitive symptoms, pain and sensory symptoms and difficulties with walking, balance and spasticity.
Associate Professor Ingrid van der Mei, principal research fellow at the Menzies Institute for Medical Research at the University of Tasmania, told the limbic it was important to recognise the potential flow-on effects of disease-modifying therapies on employment.
“Employment outcomes are a useful measure impacting quality of life. Work is so critical in terms of your self worth, financial independence, identity, etcetera.”
“And it is the symptom management that is critical to assist people to work more productively and stay in employment for longer. If we want to assist people to be more productive we really have to focus on that symptom management and other things we can think of to improve their productivity such as accommodating people who need a break during the day.”
The study concluded that future randomised controlled trials and long-term observational studies in MS should include employment outcomes to provide a more complete picture of the health economic impact of disease-modifying therapies.
The study was supported by the Multiple Sclerosis Research Australia.