Ocrevus now publicly funded for PPMS in New Zealand

Ocrevus (ocrelizumab) will be funded in New Zealand for treating certain people with primary progressive multiple sclerosis (PPMS) about six years after being approved there.

The decision from the Pharmaceutical Management Agency (Pharmac), which decides what medicines are funded in New Zealand and to what extent, makes Ocrevus the country’s first funded treatment for PPMS, a form of multiple sclerosis (MS) that affects about 10-15% of cases. It takes effect on Oct. 1.

Pharmac will allow general practitioners, along with neurologists, to prescribe Ocrevus, a move that may speed up access to treatment given the long waitlist to see a neurologist.

“We’re pleased to have a treatment option for people living with primary progressive multiple sclerosis that will make a difference to their lives, and those around them,” Geraldine MacGibbon, Pharmac’s director of Pharmaceuticals, said in a press release. “Ocrelizumab slows the progression of the condition, providing a higher quality of life, compared to current care for those living with primary progressive multiple sclerosis.”

New Zealand will also be the first country in the Asia-Pacific region and the only one of four English speaking countries with funded access to Ocrevus.

“We are thrilled with today’s announcement which will see hundreds of New Zealanders with primary progressive multiple sclerosis, and their families, be given hope that they can slow down the progression of their disease, maintaining their independence and quality of life for longer,” said Amanda Rose, the national manager of Multiple Sclerosis New Zealand (MSNZ). “For those people with PPMS who can now be helped, MSNZ urges them to contact their [general practicioner] or reach out to their local neurology team.”

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Developed by Roche’s subsidiary Genentech, Ocrevus is a disease-modifying therapy that kills B-cells, a kind of immune cell responsible for producing antibodies, including the self-reactive ones involved in the damaging inflammatory responses that drive MS.

It’s approved in New Zealand for relapsing forms of MS and is the only one OK’d there for PPMS, winning approval for both indications in 2017. Ocrevus became publicly funded for relapsing forms of MS in 2019.

Pharmac had declined to fund Ocrevus for PPMS until now, however. Only a small number of patients granted compassionate use were able to access it.

“Unless you’ve been one of the very few granted compassionate access to this drug, it’s been completely out of reach, with PPMS patients denied access to any disease modifying therapies whatsoever,” Neil Woodhams, president of MSNZ, said in a press release from the organization.

Because Ocrevus can significantly delay disease progression in PPMS — it can delay the need for a wheelchair by about seven years — the decision was met with enthusiasm by Woodhams.

“It is a decision we truly welcome,” he said.

Funded access is restricted to people with a score of 6.5 or less in the Expanded Disability Status Scale (EDSS), which indicates they are still able to walk 20 meters (about 66 feet) with or without walking aids. EDSS scores range from 0 to 10. Higher scores indicate greater disability.

“Once your disease progresses beyond that 6.5 number your access to the drug will be removed as its deemed you’ll no longer experience benefit from it,” Rose said, adding MSNZ disagrees with that stance. “People at this 6.5 level are still capable of living well and independently. Trials are ongoing into the importance of maintaining upper extremity function. We will be continuing to urge Pharmac to consider this data and hopefully in time either remove the stopping criteria altogether for all PPMS patients, or increase ocrelizumab access to 8 on the EDSS scale.”