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Survey: Neurologists Cite Therapy’s Effect on Physical Disability as Most Important Factor Influencing Prescribing Decisions in MS

MCO pharmacy directors receptive to new treatments (Mar. 20)

In a survey conducted by Decision Resources, a research and advisory firm based in Burlington, Mass., U.S. neurologists agree that a therapy’s effect on physical disability is the most influential factor when making prescribing decisions for secondary-progressive multiple sclerosis (SP-MS). The neurologists cited a therapy’s effect on quality of life as the second most important attribute, ahead of effects on relapses, imaging metrics, and other functional domains.

Current management of SP-MS relies on the use of mainline disease-modifying therapies, such as interferon-betas and glatiramer acetate (Copaxone, Teva), most of which are approved broadly for the treatment of relapsing forms of MS. This category encompasses patients with relapsing-remitting MS (RR-MS) or SP-MS who continue to experience relapses. Interviewed thought leaders suggested that, based on data in RR-MS, alemtuzumab (Lemtrada, Genzyme/Sanofi/Bayer HealthCare) may offer advantages over sales-leading glatiramer acetate on measures of physical disability, potentially translating into clinical benefits for SP-MS patients.

“The neurologists we surveyed indicate that an improved effect on physical disability is one of the greatest unmet needs in SP-MS,” said analyst Georgiana L. Kuhlmann, SM. “Drawing on clinical data from RR-MS trials, interviewed thought leaders indicate that Lemtrada has demonstrated the potential to partially fulfill this unmet need.”

According to the company, surveyed pharmacy directors in managed care organizations (MCOs) are receptive to new SP-MS therapies that offer improvements over current treatments on disability progression, as measured by the Expanded Disability Status Scale. Ninety percent of MCO pharmacy directors reported a moderate to high willingness to grant preferred formulary status to a new SP-MS therapy that offers improvements in disability progression; payers appear less inclined to grant similar status to products with improvements in other areas, particularly delivery, the company notes.

“In our survey, 65% of MCO pharmacy directors are willing to reimburse a hypothetical therapy for the treatment of SP-MS that offers once-daily oral delivery,” Kuhlmann said. “However, additional study data suggest that improvements in delivery burden may be less likely than other achievements to translate into preferred formulary status.”

Source: Decision Resources; March 20, 2013.

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