Abstract
Objectives High dose intravenous methylprednisone is the standard treatment for MS relapses. There is evidence that high dose oral methylprednisone is as effective as using the drug intravenously. However, in Australia there are substantial barriers to access the oral tablets because they are not approved by the TGA. Use of the oral formulation may have benefits in terms of health resources and patient convenience. We explored patient preference for route of administration, tolerability, and then contrast this with the cost.
Methods An online survey was sent to patients at a tertiary MS clinic asking about perceived efficacy, preference and tolerability of different formulations of methylprednisone. Costs were sought for both treatment routes and compared.
Results Fifty-two responders had received both oral and IV methylprednisolone. 65% of respondents were not dissatisfied with the oral formulation. 61% of respondents would either prefer the oral drug or had no preference. However, 75% thought that IV methylprednisone was a more effective treatment for their symptoms.
The cost per day of treatment with oral methylprednisone was $82.50 whereas with IV treatment the cost was $ 187.00.
Conclusions The cost of oral methylprednisone is substantially cheaper than the IV route. Most patients either preferred the oral formulation or had no preference, and it was comparatively well tolerated. For cost and practicality reasons we recommend services consider using the oral formulation of methylprednisolone.
