OBJECTIVES: High-efficacy disease-modifying therapies (DMTs), such as ocrelizumab (OCR), can delay disease progression and improve long-term outcomes in persons with relapsing forms of multiple sclerosis (pwRMS). However, data that compare productivity outcomes among pwRMS treated with DMTs are lacking. This study estimated long-term differences in employment status and reductions in market (formal labor) and nonmarket productivity (caregiving, volunteering and education) among pwRMS.

METHODS: An Expanded Disability Status Scale (EDSS)–based Markov model was used to estimate market and nonmarket productivity losses among pwRMS treated with OCR vs other DMTs (ublituximab, ofatumumab, natalizumab, fingolimod or dimethyl fumarate). The model leveraged baseline characteristics of pwRMS aged 18–55 years from OPERA I/II trials (NCT10247324/NCT01412333), hazard ratios from a published network meta-analysis (Lin et al. 2023) and absenteeism by disability status from the North American Research Committee on Multiple Sclerosis registry. A proxy productivity algorithm (Jiao and Basu, 2023) was used to estimate nonmarket productivity losses by EDSS. Per-patient results were scaled nationally using MS prevalence from the Institute for Health Metrics and Evaluation.

RESULTS: Estimated percent employment among pwRMS treated with OCR ranged from 58.6% (vs 56.7–58.3% for other DMTs) in year 1 to 53.3% (vs 41.7–50.9% for other DMTs) in year 10, resulting in 4.7–27.6% higher employment at 10 years for pwRMS treated with OCR vs other DMTs. Over 10 years, total productivity losses among all pwRMS in the US were lowest for OCR ($94.6 billion [B]) compared with other DMTs ($99.6B–$119.3B), translating to productivity gains of $4.9B–$24.8B.

CONCLUSIONS: A higher percentage of pwRMS treated with OCR were predicted to remain employed vs pwRMS treated with other DMTs. Over 10 years, productivity losses were lowest for OCR compared with other DMTs, highlighting the potential long-term benefits of OCR treatment for pwRMS, employers and society.