Although the use of disease-modifying treatments (DMTs) and DMT adherence in patients with multiple sclerosis (MS) appeared unassociated with out-of-pocket (OOP) payment below $442 and $890, respectively, an excessive OOP payment was a barrier to DMT access. This according to a recent study that examined the nonlinear relationship between OOP payments and DMT use and adherence, primarily to pinpoint the threshold at which the use of DMTs becomes price sensitive. Individuals with >2 MS diagnoses were identified from the MarketScan database (2006–2009). Heterogeneity in treatment was normalized by calculating an annual OOP payment as the average OOP payment for purchasing a fixed basket of DMTs at the insurance plan level. Researchers found:

• The inflection points in annual OOP payments was identified as $442 for DMT use and $890 for DMT adherence.
• For patients with annual OOP payments of >$442, a $100-increase in OOP payment was associated with a decline of 0.6% in DMT use; for annual OOP payments of >$890, a $100-increase in OOP payment was associated with 2 fewer days of DMT treatments.