The use of disease-modifying new drugs for multiple sclerosis treatment in private-sector health plans

INTRODUCTION:In Brazil, the pharmaceutical sector has requested an individual incorporation in the Brazilian public health system (SUS) for each new drug for multiple sclerosis that receives sanitary authorization for marketing. Horizon Scanning within Brazilian Ministry of Health has played a key role in the recommendations made by the National Committee for Health Technology Incorporation (CONITEC). Horizon Scanning seeks to predict which technologies have potential to impact health care in SUS, before their formal request. This study aims to present the impact of horizon scanning in two assessments made by CONITEC on drugs to treat Multiple Sclerosis.METHODS:Grey literature was searched to find new and emerging drugs for multiple sclerosis treatment. Regulatory agencies were also searched: European Medicines Agency (EMA), Food and Drug Administration (FDA) and Brazilian Regulation and Health Surveillance Agency (Anvisa). A pre-defined standardized form was used. Information extracted about each drug was identified as: drugs name, mechanism of action, indication, administration route, finished phases of clinical trial and registration in other countries.RESULTS:In 2014, horizon scanning identified seven drugs while CONITEC was assessing Fingolimod for multiple sclerosis. In this case, the drug's administration route was a differential, as only three new drugs identified were also orally administrated. Thus, Fingolimod received a positive recommendation for incorporation. In 2016, horizon scanning identified fourteen drugs while Teriflunomide was under assessment. At this moment, the orally administrated Fingolimod was already available and it was identified other eight new drugs with the same route. Therefore, the initial recommendation was against its incorporation.CONCLUSIONS:Horizon scanning has proved to be of major importance for assisting recommendation-making process of the committee. In the two cases presented, horizon scanning information could predict which technologies were being developed and could be registered in Brazil. These new technologies had influenced the recommendations made by CONITEC's members. As a result, a horizon scanning section in all CONITEC's reports became mandatory.

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Patients’ satisfaction with and views about treatment with disease-modifying drugs in multiple sclerosis

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20160091 ◽

2016 ◽

Vol 74 (8) ◽

pp. 617-620 ◽

Cited By ~ 2

Author(s):

Caroline Vieira Spessotto ◽

Hanaie Cavalli ◽

Audred Cristina Biondo Eboni ◽

Rafael Berlezi Machado ◽

Analara Munardi Mousquer ◽

...

Keyword(s):

Multiple Sclerosis ◽

Patient Satisfaction ◽

New Drugs ◽

Individual Interview ◽

Efficacy And Safety ◽

Disease Modifying Drugs ◽

Patients Satisfaction ◽

Disease Modifying ◽

Points Of View ◽

The Given

ABSTRACT Objective The treatment of multiple sclerosis (MS) with disease-modifying-drugs (DMDs) is evolving and new drugs are reaching the market. Efficacy and safety aspects of the drugs are crucial, but the patients’ satisfaction with the treatment must be taken into consideration. Methods Individual interview with patients with MS regarding their satisfaction and points of view on the treatment with DMDs. Results One hundred and twenty eight patients attending specialized MS Units in five different cities were interviewed. Over 80% of patients were very satisfied with the drugs in use regarding convenience and perceived benefits. The only aspect scoring lesser values was tolerability. Conclusion Parameters for improving treatment in MS must include efficacy, safety, and patient satisfaction with the given DMD.

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Predictive Value of the CES-D in Detecting Depression Among Candidates for Disease-Modifying Multiple Sclerosis Treatment

Psychosomatics ◽

10.1176/appi.psy.46.2.131 ◽

2005 ◽

Vol 46 (2) ◽

pp. 131-134 ◽

Cited By ~ 68

Author(s):

Rupang Pandya ◽

Luanne Metz ◽

Scott B. Patten

Keyword(s):

Multiple Sclerosis ◽

Predictive Value ◽

Disease Modifying ◽

Multiple Sclerosis Treatment

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The emergence of follow-on disease-modifying therapies for multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458519845106 ◽

2019 ◽

Vol 25 (12) ◽

pp. 1560-1565 ◽

Cited By ~ 2

Author(s):

Brandon P Moss ◽

Jeffrey A Cohen

Keyword(s):

Multiple Sclerosis ◽

Latin America ◽

Cost Savings ◽

Cost Of Care ◽

Regulatory Approval ◽

New Drugs ◽

Major Contributor ◽

Disease Modifying Therapies ◽

Disease Modifying ◽

Relapsing Multiple Sclerosis

Medication prices are a major contributor to the high cost of care for multiple sclerosis. Three generic glatiramer acetate products have regulatory approval in North America, Europe, or Latin America. The pending expiration of patents for other disease-modifying therapies for relapsing multiple sclerosis creates the opportunity for development and regulatory approval of additional follow-on alternatives (generics or biosimilars), potentially providing lower prices and cost savings to payors and patients. However, the complexities of development, regulatory approval, and marketing of follow-on products have some important differences compared to those of new drugs. This topical review provides background and a status update on the development of follow-on disease-modifying medications to treat multiple sclerosis.

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Treatment of multiple sclerosis in special populations: The case of refugees

Multiple Sclerosis Journal - Experimental Translational and Clinical ◽

10.1177/2055217319848466 ◽

2020 ◽

Vol 6 (1) ◽

pp. 205521731984846

Author(s):

Maya M Zeineddine ◽

Bassem I Yamout

Keyword(s):

Multiple Sclerosis ◽

Middle East ◽

Therapeutic Option ◽

Palestinian Refugees ◽

The Past ◽

Cost Of Disease ◽

Disease Modifying Therapies ◽

Multiple Sclerosis Disease ◽

Disease Modifying ◽

Multiple Sclerosis Treatment

Multiple sclerosis was long considered a relatively rare entity in the Middle East, but research over the past 10 years and the publication of the Middle East North Africa Committee for Treatment and Research in Multiple Sclerosis guidelines for multiple sclerosis have allowed diagnosis and treatment to occur more efficiently. Most of the first and second-line disease-modifying therapies approved by the Food and Drug Administration and the European Medicine Agency are available in the Middle East. However, the availability of disease-modifying therapies is quite variable, with some countries having access to all multiple sclerosis disease-modifying therapies, while in others there is only one therapeutic option. Economic limitations remain a challenge for the management of multiple sclerosis, especially in countries of war. Moreover, the burden of multiple sclerosis treatment in Syrian and Palestinian refugees is likely high due to the non-availability of funds to cover the high cost of disease-modifying therapies.

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Working-age persons with multiple sclerosis and access to disease-modifying medications

Multiple Sclerosis Journal ◽

10.1177/1352458507080466 ◽

2008 ◽

Vol 14 (1) ◽

pp. 112-122 ◽

Cited By ~ 8

Author(s):

L.I. Iezzoni ◽

L.H. Ngo ◽

R.P. Kinkel

Keyword(s):

Multiple Sclerosis ◽

Health Insurance ◽

Health Plans ◽

Prescription Medications ◽

Regression Analyses ◽

Access To Services ◽

Financial Barriers ◽

Telephone Surveys ◽

Working Age ◽

Disease Modifying

US residents can face serious financial barriers to obtaining prescription medications, including disease-modifying medications for multiple sclerosis (MS). We conducted 30-min telephone surveys with 983 persons with MS nationwide, 21—64 years old, to explore how financial and health insurance concerns affect access to services including MS drugs. Almost everyone (96.3%) had some health insurance. Multivariable logistic regression analyses accounted for demographic, disease and insurance characteristics. Only 10.8% of those <40 years old had never received disease-modifying medications, compared with 41.1% of persons aged 60—64. Among the uninsured, 36.8% reported having never taken these medications, compared with 21.2% of persons with health insurance. Adjusted odds ratio (95% CI) of using these drugs in prior 12 months among the uninsured (compared with insured persons) was 0.28 (0.08, 0.95). Just over 16% of persons with public health plans reported that their insurer initially denied coverage for MS medication. When asked about MS medications in general, 22.3% reported having not filled prescriptions, skipping doses or splitting pills because of cost concerns; 22.4% worried `a lot' about getting MS medications when they needed them. Substantial fractions of persons with MS confront financial and health plan-related barriers to obtaining MS drugs. Multiple Sclerosis 2008; 14: 112—122. http://msj.sagepub.com

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Disease Modifying Drugs in Multiple Sclerosis: Mechanisms of Action and New Drugs in the Horizon

CNS & Neurological Disorders - Drug Targets ◽

10.2174/187152712801661301 ◽

2012 ◽

Vol 11 (5) ◽

pp. 610-623 ◽

Cited By ~ 21

Author(s):

Monica Marta ◽

Gavin Giovannoni

Keyword(s):

Multiple Sclerosis ◽

Mechanisms Of Action ◽

New Drugs ◽

Disease Modifying Drugs ◽

Disease Modifying

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Advances in Multiple Sclerosis

European Neurological Review ◽

10.17925/enr.2017.12.01.13 ◽

2017 ◽

Vol 12 (01) ◽

pp. 13

Author(s):

Ioannis Milonas ◽

Keyword(s):

Multiple Sclerosis ◽

New Drugs ◽

Disease Modifying Drugs ◽

Disease Modifying ◽

New Treatments

There are an increasing number of new drugs in the treatment of multiple sclerosis (MS). These new treatments along with the use of the older disease modifying drugs provide the neurologist with an increasing number of options in treatment of MS patients. These treatments have also contributed to the better understanding of the underlying immunopathology of the disease.

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