Pharmacy Directors are Most Convinced to Reimburse Multiple Sclerosis Drugs Supported by Data Showing Significant Reductions in Relapses
NASHVILLE, Tenn. and GLEN ROCK, N.J. June 24 /PRNewswire/ — HealthLeaders-InterStudy and Fingertip Formulary find that surveyed pharmacy directors indicate a new multiple sclerosis (MS) treatment must demonstrate a reduction in the number and/or frequency of relapses in order to achieve equal reimbursement to current brands. According to the new Formulary Forum report entitled Formulary Advantages in Multiple Sclerosis: How Will Price Impact the Uptake of Emerging Orally Delivered Therapies?, a reduction in relapses is important because of its two-fold effect on costs: reducing both prescription drug spending and the non-drug costs related to treatment, including diagnostic testing and follow-up office visits.
As pharmacy directors attempt to limit MS treatment-related costs, managed care organizations will increasingly look to clinical trial endpoints to evaluate the relative efficacy of MS therapies. Physicians frequently look for changes in a patient’s score on clinical disability measures such as the Expanded Disability Status Scale or MS Functional Composite to evaluate an MS drug’s efficacy in slowing disease progression.
“Surveyed pharmacy directors report non-prescription-drug spending for MS contributes as much, if not more, to total treatment costs as prescription drug spending,” said Analyst MaryEllen Klusachek, Ph.D., author of the report. “With cost-containing efforts in mind, pharmacy directors will be evaluating a drug’s ability to reduce the number or frequency of relapses, as well as its ability to delay disability progression when making reimbursement decisions, placing less emphasis on a new drug’s minor side effect profile.”
The new Formulary Forum report is based on a survey of 51 U.S. pharmacy directors who control formularies at national, regional and state-level managed care organizations, as well as historical formulary data from Fingertip Formulary.
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