Episode 10 - Treatment Complexities

During this segment, the panelists discuss why treating multiple sclerosis (MS) is complex. Patricia K. Coyle, MD, explains that there is a lack of updated versions of clinical guidelines, and Gary M. Owens, MD, discusses the need for individualized therapy and its effect on drug cost comparisons when reviewed by managed care professionals.

Dr Coyle explains that old guidelines published by the American Academy of Neurology are reviewed by practitioners strictly to review data, and are referred to as “basic principles.”

When reviewing an agent’s effectiveness and making treatment decisions, Dr Coyle and Leslie Fish, PharmD, explain that neurologists review a drug’s safety, efficacy, tolerability, and the extent of the patient’s disease, among other patient factors. Dr Coyle further explains that there is a need for improved biomarkers.

Additionally, when managed care reviews the costs of MS agents, Dr Owens believes that because most drugs are therapeutically equivalent, the lowest priced options are the most popular. Another issue, as explained by Dr Owens, is that payers are making judgment calls about treatment based off evidence studied in populations, even though MS necessitates an individualized treatment approach.As Patricia K. Coyle, MD, Leslie Fish, PharmD, and Gary M. Owens, MD, discuss outstanding issues related to the treatment of multiple sclerosis, the panelists conclude that there is a need for improved biomarkers, and recognize that MS necessitates individualized treatment, which impacts cost comparison decisions made by managed care professionals.