The Pharmaceutical Management Agency (PHARMAC) is considering a funding proposal that includes five treatments for multiple sclerosis (MS), namely two key MS drugs, Biogen‘s Tysabri and Novartis‘ Gilenya, that are not currently funded. PHARMAC is the New Zealand Crown agency that decides, on behalf of District Health Boards, which medicines and related products are subsidized, which means that natalizumab and fingolimod may start to be prescribed by the New Zealand community and public hospitals.
The proposal that will go into effect beginning on November 1st, 2014 include the funding of natalizumab (Tysabri), produced by Biogen, as well as fingolimod (Gilenya), which is produced by Novartis, in the New Zealand community and in DHB hospitals, subject to restrictions. It also includes changes to the restrictions for funded access, in both the community and DHB hospitals, for interferon beta-1-alpha (Avonex), interferon beta-1-beta (Betaferon), and glatiramer acetate (Copaxone).
“About 600 people currently receive funded treatment for MS and we estimate, should this proposal be approved, around 87% of these people would be eligible to change to the new treatments,” the proposal states. “The other 13% could continue receiving their existing funded treatment. In addition, should this proposal be accepted, we estimate that about 400 more people with MS would become eligible for funded treatments during the next five years.”
Tysabri is an MS treatment specifically indicated for treating physical disability and patients who haven’t seen results with other courses of treatment. It is administrated every four weeks as an infusion and it reduces flare-ups by 67 percent, according to a two-year placebo controlled study conducted by Biogen. Tysabri also showed substantial benefits in protecting MS patients against relapses, according to another study recently published in JAMA Neurology. However, it is also known that patients who are prescribed Tysabri have an increased risk to develop the rare, often fatal infection of the brain called progressive multifocal leukoencephalopathy (PML), which is caused by a common virus that infects blood cells.
Gilenya is a first-in-class sphingosine 1-phosphate receptor modulator, which works by blocking lymphocyted in lymph nodes and preventing them to concur to an autoimmune reaction, currently used in treating persons with severe relapsing remitting MS. The substance has been proved effective in the treatment of other conditions, as Post Traumatic Stress Disorder (PTSD) or in reducing the pain caused by chemotherapy.