University-educated MS patients are more likely to get DMT: Study

People with multiple sclerosis (MS) who received a university-level education are more likely to be on disease-modifying treatment (DMT) in regions with a publicly funded healthcare system, a U.K.-based study suggests.

Advanced education was also linked to treatment starting faster and high-efficacy therapies being utilized more frequently.

“Participants with a university education had a higher uptake of DMTs, in particular, high-efficacy DMTs, than those without a university education,” researchers wrote, underscoring a need for further study about how education affects treatment access to promote equitable access to healthcare.

The study, “University education facilitates uptake of disease-modifying therapies for multiple sclerosis: A community-based study using the UK MS Register,” was published in Multiple Sclerosis Journal. 

Disease-modifying treatments, or DMTs, are anti-inflammatory medications that slow the progression of MS, decreasing the likelihood of disease flares, MRI activity, and worsening disability.

Though they can effectively control MS, these medications carry high price tags. Previous studies in countries with private health insurance systems have found that college-educated MS patients are more likely to be on DMTs, but, because people with a college education also tend to have more money, it’s been difficult to determine if this is due to being educated or a result of greater economic freedom.

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In this study, scientists studied whether having a university education is also a predictor of DMT use in the U.K., which has a publicly-funded healthcare system. Using information from the U.K. MS Register, they identified data on more than 6,300 people with MS in the U.K. Just under half (46%) had a university education.

Nearly two-thirds (62%) of the university-educated MS patients were treated with DMTs, a significant difference from the 53% with school education or a diploma who received a DMT. In statistical models, the higher rate of DMT use among university-educated patients was significant even after accounting for other factors, such as age and sex, age at diagnosis, and physical quality of life.

DMTs for MS can be broadly divided into two categories: moderate-efficacy DMTs, which are less potent but generally well tolerated, and high-efficacy DMTs, newer, more potent meds that carry greater safety risks. A university education was predictive of a greater likelihood of using either category, models showed.

Among those on a DMT, patients with a university education were more likely to get a high-efficacy therapy. The time between MS diagnosis and starting a DMT was significantly shorter for college-educated patients, said the researchers, who emphasized that the effect of education on DMT access in this study was less dramatic than studies in countries with privately funded healthcare systems. This is presumably because economic barriers pose less of an obstacle to DMT use in publicly funded healthcare systems, the researchers said.

The findings underscore a need to better understand how education affects treatment access even when economic barriers aren’t part of the equation.

“In a publicly funded health care system, the impact of education on the uptake of DMTs is unlikely to be caused by many direct costs, as people are not required to pay for appointments, investigations, drugs and other care. Further studies are therefore required to understand the mechanism that drives this inequity, to improve health care access,” the scientists said.