Health Care Insurance Coverage and Treatment Patterns Among U.S. Patients with ALS

People with amyotrophic lateral sclerosis (ALS) require complex treatment and a range of pharmacological support. However, limited information is available about the burden on different health care providers in the United States. A study presented at AMCP Nexus 2021 sought to elucidate health care insurance and the related treatment landscape among patients with ALS in the U.S.

To conduct this analysis, researchers collated data between July 2020 and March 2021 as part of the Adelphi ALS Disease Specific Programme™, a real-world, point-in-time survey of American neurologists and their consulting patients with ALS. A team of 55 neurologists recorded patient demographics (including insurance coverage), clinical characteristics, and treatment information. In total, the analysis reported data for 372 patients with ALS, grouped according to insurance coverage: Medicaid/Medicare only (55%), commercial insurance (including private or employer arranged; 36%), and other insurance (9%).

Compared to patients with commercial or other insurance, patients covered under Medicaid/ Medicare were older (mean age, 55.2 and 59.9 years vs. 62.4 years, respectively) and had been diagnosed for longer (10.4 and 17.3 months vs. 19.7 months). The results showed that patients covered under Medicaid/Medicare experienced twice as many changes to their coverage due to ALS than those with commercial insurance (12% vs. 6%). Of these instances, more than half (54%) were due to a loss of employer coverage following an ALS diagnosis.

The investigators observed that patients covered under Medicaid/Medicare were prescribed fewer drug treatments overall than those with commercial and other insurance (2.3 versus 2.8 and 2.8, respectively). Moreover, they were less frequently prescribed disease-modifying treatments than those with commercial insurance (76% vs. 83%).

“In this study, about one-third of patients with ALS were covered under commercial insurance and had access to a greater range of treatment options. The remaining ALS patients were covered under Medicaid/Medicare or other insurance options. These patients were older and further along in the disease course, where health care resource utilization is likely to be higher,” the investigators concluded.

Source: Haagan M, et al. Health Care Insurance Coverage and Treatment Patterns Among Patients with Amyotrophic Lateral Sclerosis in the United States. Poster G9.Published for AMCP Nexus 2021; October 18-21, 2021, Denver, CO.