It is wonderful to see some momentum behind the off-label use of DMTs for treating MS. Since the Swedish experience with rituximab was published a few weeks ago the position paper on reducing the cost of MS treatments below came to my attention with an accompanying blog post, ‘Stand-up for Rituximab‘.
…… The unaffordability of MS medications is driven by the outrageous prices that are in no way tied to the benefits these medications provide….
Kister & Corboy. Reducing costs while enhancing quality of care in MS. Neurology October 11, 2016 vol. 87 no. 15 1617-1622
The rapid escalation in prices of disease-modifying therapies (DMTs) for multiple sclerosis (MS) over the past decade has resulted in a dramatic overall increase in the costs of MS-related care. In this article, we outline various approaches whereby neurologists can contribute to responsible cost containment while maintaining, and even enhancing, the quality of MS care. The premise of the article is that clinicians are uniquely positioned to introduce innovative management strategies that are both medically sound and cost-efficient. We describe our “top 5” recommendations, including strategies for customizing relapse treatment; developing alternative dosing schedules for Food and Drug Administration–approved MS DMTs; using off-label therapies for relapse suppression; and limiting the use of DMTs to those who clearly fulfill diagnostic criteria, and who might benefit from continued use over time. These suggestions are well-grounded in the literature and our personal experience, but are not always supported with rigorous Class I evidence as yet. We advocate for neurologists to take a greater role in shaping clinical research agendas and helping to establish cost-effective approaches on a firm empiric basis.
Oct 18, 2014 … “In response to some of the comments yesterday I have to stand up for people living with MS in South Africa and defend their right to treatment.