Questions of Adherence Raised by Unused Multiple Sclerosis Disease-Modifying Therapies: Darin T. Okuda, MD; Karin Cook


The coauthors of a study assessing costs associated with unused disease-modifying therapies shared their insight into the extended effects of unused treatments in MS, including the importance of transparency between physician and patient. [WATCH TIME: 12 minutes]

WATCH TIME: 12 minutes

“A number of questions came up as a result of these experiences. For me, at least, I wonder what proportion of patients are being forthcoming with respect to their true degree of compliance and adherence.”

The patient-physician relationship is crucial to establishing and maintaining an appropriate and successful treatment regimen for chronic disease. But, for physicians such as Darin T. Okuda, MD, even a relationship that appears to be built on transparency can be mired by external factors that are unknown to the physician. Many patients, for a variety of reasons, fail to remain honest about their use of their prescribed treatments or their health-related behaviors—even Okuda admits he trains for his annual physical.

In a recently published dataset, Okuda a professor of neurology and the director of Neuroinnovation and the Multiple Sclerosis & Neuroimmunology Imaging Program at The University of Texas Southwestern Medical Center at Dallas, and colleagues looked into the process for unused disease-modifying therapies (DMTs) in the treatment of multiple sclerosis (MS). The effort was an attempt to identify what happened to these therapies when their prescriptions were not completely used. Since the beginning of their work, Okuda noted that the group has collected more than $23 million in unused disease-modifying therapies.

Along with coauthor Karin Cook, senior vice president of medical strategy and clinical ethnographer, Heartbeat Medical Communications, who offered her perspective from the non-neurologist viewpoint, Okuda spoke with NeurologyLive® about the importance of maintaining that relationship to best select the proper DMT for patients, and about the modern factors in medicine that contribute to the high rates of nonmedical reasons for therapy switch that he and Cook observed in their study, among others topics.

SEE MORE: Wasted DMTs in Okuda's Office [Image]

1. Okuda DT, Burgess KW, Cook K, McCreary M, Winkler MD, Moog TM. Hiding in plain sight: the magnitude of unused disease-modifying therapies in multiple sclerosis and strategies for reducing the economic burden. Mult Scler Relat Disord. 2022;63:103920. doi:10.1016/j.msard.2022.103920
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