Ocrevus Is Popular Among Neurologists, but Insurance Is a Growing Concern, Report Concludes

Ocrevus Is Popular Among Neurologists, but Insurance Is a Growing Concern, Report Concludes

Ocrevus’ (ocrelizumab’s) market introduction is off to a stellar start, with nearly half of neurologists surveyed by Spherix Global Insights saying they are using the therapy — the first ever approved for both relapsing and primary progressive multiple sclerosis (MS).

Within six months, 80 percent of neurologists are expected to prescribe Ocrevus, according to a report in the second-quarter edition of RealTime Dynamix: Multiple Sclerosis by Spherix Global Insights.

But insurance is having an increasing impact on treatment decisions, the report also found, according to a Spherix press release. More patients are receiving less than optimal care because of inadequate or inferior insurance coverage, and neurologists report that insurers have become more aggressive in managing MS patients.

Surveying 104 neurologists in June, the report showed that physicians followed through with their intent — reported in earlier surveys — to prescribe Ocrevus as it became available.

With Ocrevus being the first approved drug for primary progressive MS, these patients make up a sizable part of those receiving it. But patients with relapsing forms of MS represent more than half of new users, according to the report.

Ocrevus was also, by far, the drug that neurologists had learned most about, and felt most excited about using, the report added.

Most of the patients on Ocrevus were switched from Biogen‘s Tysabri (natalizumab) or Rituxan (rituximab) — a drug that, like Ocrevus, is also produced by Genentech/Roche. One in five patients was switched from an oral disease-modifying treatment, mainly Biogen’s Tecfidera (dimethyl fumarate).

But for about 25 percent of Ocrevus-treated patients, the drug is the first disease-modifying therapy they have received.

The survey also revealed that patients are the driving force behind new Ocrevus prescriptions. Seventy-one percent of neurologists receive requests from patients who want to start the treatment.

While neurologists have to turn some of these requests down for various reasons, a large proportion of those who ask for the treatment receive it.

Another insight from Spherix’s “RealWorld Dynamix: DMT Brand Switching in MS” survey was that patients’ requests for a specific brand are often honored. Seventy-seven percent were prescribed the brand they requested, the survey showed. Interestingly, neurologists believed the number to be lower.

Most patients who made a specific request, the report indicated, asked for Tecfidera in the past year and a half. Tecfidera is by far the leading oral disease-modifying drug prescribed in MS.

Meanwhile, according to the report, Biogen’s Avonex (interferon beta-1a), Bayer‘s Betaseron (interferon beta-1b), Teva‘s Copaxone (glatiramer acetate), and EMD Serono‘s Rebif (interferon beta-1a) continue on a downward path. At least 30 percent of neurologists report lower use of these therapies in the past three months.

Patients previously on these drugs are mainly switched to oral disease-modifying drugs. But this trend is projected to slow, with only Sanofi-Genzyme‘s oral Aubagio (teriflunomide) continuing to grow.

But the choice of treatment may increasingly be driven by insurance. Compared with the same quarter of 2016 — when neurologists estimated that 14 percent of patients received suboptimal treatment because of poor insurance coverage — 20 percent of patients are now judged to be in this situation.

Also, 60 percent of surveyed physicians feel that insurance companies have become more aggressive in MS treatment management. A similar percentage also say that insurance policies influence how they prescribe specific disease-modifying drugs.

10 comments

  1. B. Marsh says:

    I have spent my entire life around medicine, both academic (including one of the best in the world) and clinical. BE CAUTIOUS, unless very desperate, with newly approved medications. They wisk them through clinical trials MUCH too quickly in the FDA. THIS was only approved Mar. 28th, 2017. In less than the first two months a brain infection was already reported and we don’t know how many other things went unreported.

  2. Jeanine Shahin says:

    Insurance companies dictate too much. I very much agree with the above statement. I would rather use Rituximab because it has been around for years. However, good luck in trying to get insurance to pay. Good news Genentech has a patient assistance program.

  3. Dr Mark Hughes says:

    The risk of malignancy seems to be an anomaly from the clinical study where, by a quirk of fate no malignancies were seen in the comparator group and the overall incidence is similar or less than seen in the general population. But time will tell. And the brain infection was nothing to do with Ocrevus, it was seen in a patient who had been on Tysabri for years and had recently switched to ocrevus and had just received a single dose.

    • B. Marsh says:

      Ocrevus was pressured on a patient I happen to know who had an immediate family member (sibling) die in the last few years of neuroendocrine carcinoma. I don’t think that was a great idea. The MS patient thank God, refused. I’m sorry, but unless it is an extremely fast progressive case of MS in any patient, family hx of malignancies or not, suppressing the immune system is not my preference.

  4. David Dunn says:

    I agree with Maggie. Finally a drug for us PPMS people. I will be first in line, once it’s approved in Canada.

  5. Olivia T. says:

    I was diagnosed over 11 yrs ago at the age of 27. I’ve been on many DMD’s and they all have their side effects. I am fortunate that I still have my mind and I am not severely handicapped yet. However, during a recent neurology visit, we are starting to see increased deficits in cognitive function and increased physical changes (coordination, balance, response times, etc.). I currently take Copaxone 3x per week. My neuro gave me something to think about: “Do you want the technology of 20 yrs ago or latest and greatest for what we know today?” Seeing changes, all of the research that is out there, one weighs the risks and benefits of known vs. unknown and new. Sometimes it is a personal choice that I am ready to act more aggressively with this disease. I am going to fight to keep what I have left for as long as possible and don’t have time to waste and wait for more data. I will start infusions of Ocrevus on 18 Aug. There are risks with each of the medications out there. However, research is showing reactions and side effects of Ocrevus are small. I am ready to take Ocrevus, which is hopefully just as aggressive as the MS, to fight back and try and take back control. It’s not a cure but I am hopeful that it will buy me some time until the next best drug comes along.

    • Jose says:

      I am currently on Ocrevus, my first infusion was 8/15/2017 & the flu like symptoms are for real. I am PPMS & waiting for the cure. Call me then. I have been on 7 MS meds and I’m done.

  6. Kathleen says:

    I just finished the second of the initial 2 infusions. I was fortunate to have no side effects whatsoever. I don’t know how anyone could afford this without insurance and the patient assistance from the company. My copay would have been $4000, but with the patient assistance it was less than $35. I am PPMS and pretty far along with it. Ocrevus is the only game in town for us. Just hoping to hang on to what little I have left for as long as possible.

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