In a session titled “Challenges for care and research in MS outside Europe and North America” at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) 2016 Congress Sept. 14-17 in London, researchers from Latin America shared the obstacles of scientists and multiple sclerosis (MS) patients in the region.
Jorge Correale, from Argentina’s Institute for Neurological Research Dr. Raul Carrea, FLENI, explained how healthcare budget restrictions throughout Latin America limit access to proper treatment for MS patients.
In most countries in the region, MS treatment is covered by the government through hospitals or social security institutes. MS drugs, however, are generally restricted to steroids and used only for the management of acute relapses. Access to symptomatic medications and rehabilitation services is also limited.
Most countries in Latin America have limited access to disease modifying therapies, and although some regional regulatory bodies have approved the use of certain MS therapies, local health systems may not cover the costs. Also, social security-funded treatment is awarded only to people who are employed and their families.
Perceived high costs of MS drugs make regulators provide generic drugs and biosimilars instead of original brands of MS medications. But Correale noted that the cost of generics and biosimilars are often not significantly lower than original drugs, while many of the compounds provided in them lack data on safety and effectiveness.
The researcher also reported that excessive regulation and bureaucracy often contribute to patients abandoning their treatment, and that the use of generics and biosimilars can lead to drug interchangeability problems, further worsening patients sticking to a treatment regimen.
Marco Lana-Peixoto from the Federal University of Minas Gerais in Brazil focused on the poor quality of epidemiological research on MS in the country. Brazil is a huge country with people of diverse genetic backgrounds.
Lana-Peixoto argued that epidemiological studies of MS in different regions of Brazil are needed to better understand the problem. Although studies are being performed, he said that few use robust epidemiological methods.
An ongoing study by the Brazilian Committee for Research and Treatment in Multiple Sclerosis (BCTRIMS) is exploring how common MS is in cities that are representative of certain regions in terms of their population.
Southern and southeastern regions are believed to have higher rates of MS than central and northern parts, since European ancestry is more common and southern areas are farther from the equator.
These data echo a fact presented by Correale, showing that the scarcity of clinical trials in the region led to a lack of knowledge of how the genetic backgrounds of people impact the response to MS drug treatment.
Lana-Peixoto pointed out similar issues as Correale in stating that few MS centers in Brazil can offer patients the multidisciplinary care they need, as both knowledge and funding are in short supply.
“Improvement of medical education, increased disease awareness by the general population, and collaborative work between MS specialists and health authorities may change the present panorama of MS care and research in Brazil,” Lana-Peixoto wrote in the Congress’s abstract.