Socioeconomic determinants of clinical outcomes in multiple sclerosis patients

Background Multiple sclerosis (MS) is a chronic condition that affects the central nervous system. Factors such as insurance coverage and income influence its prognosis. Objectives To evaluate whether insurance type and socioeconomic factors, including race and ethnicity, employment status, and transportation difficulties affect disease-modifying treatment (DMT) access and clinical outcomes in MS. Methods We performed a retrospective chart analysis of patients with MS treated at Rush University Medical Center. Patients were divided based on primary insurance. Primary outcomes were number of clinical relapses, radiological activity, and Expanded Disability Status Scale score at 18 months. The secondary outcome was time to DMT initiation from the time of diagnosis. Results This study included 160 patients: 119 had private insurance and 41 had Medicaid. Patients with Medicaid were more likely to experience delays in DMT initiation, clinical relapses, and disability progression. There was no significant difference in time of DMT initiation in patients with Medicaid versus private insurance after adjusting for baseline covariates. We did not find a significant media effect of DMT delay on any clinical outcomes. Conclusions In this study, Medicaid coverage was associated with worse clinical outcomes, including more clinical relapses and higher EDSS progression compared to privately insured patients.