Cost of treatment

Ocrevus (ocrelizumab) is a less expensive treatment option for relapsing multiple sclerosis (MS) than subcutaneous interferon beta-1a (Rebif) in the long-run, according to a cost-effectiveness analysis published in the Journal of Medical Economics. In addition to lower total costs over a 20-year period, the analysis suggested that Ocrevus…

MS drug manufacturers are in the sights of two members of Congress The companies are Bayer, Biogen, EMD Serono, Novartis, Sanofi Genzyme, Teva, and Roche. U.S. Reps. Elijah Cummings and Peter Welch, two Democrats who sit on the House Committee on Oversight and Government Reform, are concerned about what they're calling dramatic price increases for some MS drugs produced by those companies. In a news release, the congressmen say the price hikes have come "without warning, cause, or justification." They've sent letters to the companies seeking information about their profits and expenses. The letters also ask for documents about pricing strategies, patient assistance programs, and drug distribution systems. Cummings and Welch point to an American Academy of Neurology study of drug prices as evidence that some pharmaceutical companies appear to be increasing the prices of their older, less expensive drugs to bring those prices in line with those of the newer, more expensive DMTs that are available today. This kind of practice is known as “shadow pricing.” The congressmen refer to this study as being a bit dated, as it was published in May of 2015. It reviews the published prices of nine DMTs over a 20-year period, ending in 2013, and shows that prices for those older, first-generation DMTs increased at an annual rate that was five to seven times higher than general prescription drug inflation. In their news release, the lawmakers also referred to a report from the National Multiple Sclerosis Society that included a chart of drug price increases since the approval date for each drug.

Insurance companies want people to use generics, rather than the more expensive brand-name drugs, right? Maybe not. Because, at least in some cases, they’re doing just the opposite. Some patients are being forced to use brand-name drugs even when those drugs have generic equivalents. Not surprisingly, that means…

I have written multiple iterations of this column trying to keep pace with the disastrous healthcare bills being presented first in the U.S. House of Representatives and now the Senate. But I can’t keep up with them. There are just too many and…

Costs associated with multiple sclerosis increase as the disease worsens, according to a study of more than 16,000 patients in 16 European countries. The study, “New insights into the burden and costs of multiple sclerosis in Europe,” was published in the Multiple Sclerosis Journal. Researchers obtained their information from patient self-reporting. Patients used the Kurtzke's Expanded Disability Status Scale (EDSS) to assess the severity of their disease. They also reported on their quality of life and their resource use. Patients were divided into three categories. Those with a score between 0 and 3 on the EDSS scale were deemed to have a mild disease. The disease of those with scores of 4 to 6.5 was considered moderate. And the disease of those with scores of 7 to 9 was classified as severe. Patients assessed their health-related quality of life with the EuroQol Five Dimensions questionnaire. The average age of the 16,808 participants was 51 and a half years old. The work capacity of MS patients dropped from 82 percent of a healthy person's to 8 percent as the severity of the disease increased, researchers said. Patients' quality of life scores were about the same as those seen in the general population when they had a mild disease. But they plunged to less than zero when their disease became severe. The mean annual cost of having a mild form of MS was 22,800 euros, or around $26,300, researchers reported. The cost of having a moderate disease was 37,100 euros, or about $42,800. And the cost of a severe disease was 57,500 euros, or $66,340. Healthcare accounted for 68 percent of total costs with a mild disease, 47 percent with a moderate disease, and 26 percent for a severe disease. "Costs are dependent on the availability, use and price of services and on disease severity," the researchers wrote. "Costs were related to disease severity" in all countries "and were dominated by production losses, non-healthcare costs and DMTs," or disease-modifying therapies. Those therapies may be a key reason why the highest percentage of healthcare costs occurred in patients with a mild disease, researchers said. Doctors prescribe a lot of DMTs to this group. Other factors related to the high percentage were that many patients with mild diseases are still able to work -- meaning they incur fewer production-loss costs -- and this group requires fewer community services. As MS becomes more severe, patients' production losses rise, and they use more community services. "The intensity of healthcare service use varied widely across the countries," researchers wrote. "This reflects differences in healthcare organization, medical traditions, ease of access and – most importantly – availability of given services." Researchers also assessed patients' levels of fatigue and cognitive difficulties. Ninety-five percent reported fatigue, and 71 percent cognitive difficulties. Fatigue and cognitive difficulties had significant impacts on quality of life scores, researchers said.

A recent study has found that continued use of Ampyra (dalfampridine extended-release, sold in the U.S. by Acorda Therapeutics) by patients with multiple sclerosis (MS) lowers both inpatient hospital visits and overall healthcare costs. Results from the study, titled “Inpatient Admissions and Costs Associated with Persistent…

A few weeks ago, I wrote about some of the invisible costs of living with MS. Writing that column really got my mind thinking about all the ways that my MS costs me money. In fact, I couldn’t stop thinking about it! In the days that followed, I…

I’ve just been reminded, as someone with multiple sclerosis, how fortunate I am to have good medical insurance. Unlike most other countries, where medical care is a right, in the U.S. that care is a privilege. Here the quality of care and too often the availability of that…

MS is sneaky. It is expert at evading detection and diagnosis, and often brings a host of invisible symptoms that may come and go at random. MS also brings invisible costs — expenses beyond the obvious medications, supplements, assistive devices, and healthcare. I am not talking about externalities,…

There’s been lots of chatter on social media since the U.S. House of Representatives passed a measure last week that’s intended to repeal the Affordable Healthcare Act (Obamacare) and replace it with a new healthcare law. Lots of us with serious medical conditions are: a) worried, b) angry,…

With last month’s approval of the multiple sclerosis drug Ocrevus, I’ve again heard the plea “But how can I afford it?” Ocrevus carries a price tag of about $65,000 a year. That’s not high compared to some other MS drugs, but it still can mean a higher…

Liberation therapy was seen to be an ineffective treatment — both in the short and long term — in a Canadian study in people with multiple sclerosis (MS), its researchers reported, advising patients not to assume the procedure’s risks or cost. Lindsay Machan, a radiology professor at the University of British…

The sky-high costs to Medicare for prescriptions of the MS medication H.P. Acthar Gel,  as reported in Multiple Sclerosis News Today were highlighted at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) 2017 Forum in…

As Republicans in Congress prepare to repeal and replace the Affordable Care Act (ACA), the National Multiple Sclerosis Society and 10 other nonpartisan patient groups are urging lawmakers in Washington to keep health insurance affordable, accessible, adequate and understandable for all Americans. The 11 organizations will evaluate all proposed changes to the…

Medicare spent more $650 million in 2013 and 2014 on one single medication — H.P. Acthar Gel —— that was prescribed by fewer than 1 percent of clinicians to treat multiple sclerosis (MS), with questionable results. That’s the conclusion of new research by Oregon Health and Science University (OSHU), which presented its…

A lot of factors go into our decisions when we select the drug we’re going to use to fight our multiple sclerosis. How well will it work? What are the possible side effects and how serious could they be? How will using the drug (taking a pill, giving myself a…

People with multiple sclerosis (MS) and other chronic diseases value the Affordable Care Act (ACA, also known as Obamacare) more than the general public, concludes a poll conducted by PatientsLikeMe. These patients are also less inclined to repeal Obamacare, and they are more likely to believe Obamacare needs few changes to…

After my recent insurance experience, which I share here, I never again will wonder why some people give up on claiming their medical benefits. I have received Botox treatment for spasticity of my quad and hamstring muscles. This is an FDA-approved use, but to get this treatment there has…

I don’t think this will surprise you. Multiple sclerosis drugs, some of the most expensive drugs there are, are getting even more expensive. Drug industry analyst Eric Schmidt, quoted in the Boston Business Journal, reported that Biogen began the new year by upping the price of Tecfidera,…

A cost-effectiveness analysis of reimbursement recommendations for four relatively new multiple sclerosis (MS) treatments made by agencies in four countries — Australia, Canada, Sweden, and the U.K. — found overwhelming support (88 percent) for either full or restricted reimbursement for each therapy. The analysis, performed by the Decision Resources Group, is…

“… in 3 years we went from living decent not rich to poverty and will prob have no utilities soon and maybe homeless.” An MS patient wrote that after I posted Part I of this column a few days ago. “I went threw (sic) all of our savings…

I’m not asking for your money.  (At least not yet.)  But I’ve recently seen a lot of news stories about MS patients who are. Multiple sclerosis battler fights for $200,000 treatment Or… Fundraiser for Deanna Or… Burbage dad’s £50,000 appeal to…

It’s that time of the year. Drug insurance companies in the U.S. are making changes to their formularies — the list of drugs that your insurance company will pay for. Those formularies change from year to year so you need to be alert to changes that may impact your…

The National Multiple Sclerosis Society has launched an initiative, called Make MS Medications Accessible, calling for change in the pricing of multiple sclerosis (MS) medications in the U.S., which the group said need to be more affordable, and ways of acquiring them more simple and transparent. The initiative asks leaders of all…

If only we were cherub faced children, then perhaps someone would have listened to us in the past few years as we voiced concern and then outrage over the escalating costs of our MS disease modifying therapy (DMT) drugs. I’ve listened to the outcry in recent weeks about the astronomical…

At the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) 2016 Congress, taking place in London on Sept. 14–17, Biogen will present the Multiple Sclerosis Cost of Illness study, based on research into more than 16,000 MS patients throughout Europe. The study builds on data from a leading 2005 study that…

Anyone with a chronic medical problem knows how expensive drugs can be, and how a drug that you need can be here today … gone tomorrow on the list of drugs that your health plan will pay for. You also know that cost and insurance coverage aren’t the only…

The CVS Caremark covered insurance plan has dropped Avonex, Plegridy and Extavia, three multiple sclerosis disease-modifying therapies, from their 2017 formulary. You say, OK, but what does that really mean? If your prescription insurance is through CVS Caremark, and you want one of those drugs or one…

  We may have international cooperation and worldwide this and that, but the fact remains that countries vary drastically from one another in all sorts of ways. Take healthcare as an example, and the costs of treatment. Yes, we have the World Health Organization and there are various health-related initiatives…

Multiple sclerosis (MS) patients in the U.S. with higher disability scores also have higher rates of health resource utilization, higher healthcare costs, and lower work productivity and health-related quality of live, according a study by researchers at Adelphi Real World and Abbvie. The study, “Quantifying the…