Novel Treatments and Strategies For Relapsing Multiple Sclerosis

Gary Owens, MD, a managed health care consultant and a First Report Managed Care Editorial Advisory Board member, presented “Improving Patient Outcomes with Novel Treatments and Strategies in the Management of Relapsing Multiple Sclerosis,” during the population health management track sessions of the NAMCP 2017 Spring Managed Care Forum. 

Dr Owens’ presentation covered the latest advancements and strategies for managing patients with relapsing multiple sclerosis (MS). According to Dr Owens’ presentation, MS prevalence in the United States is more than 400,000 cases, with 8500 to 10,000 new cases diagnosed every year. The presentation noted that most cases are diagnosed between the ages of 15 and 45 with women outnumbering men 3 to 1. Additionally, 85% of patients are diagnosed with relapsing-remitting MS and without treatment more than half of these patients develop secondary progressive MS and become significantly disabled within 10 years of diagnosis. 

According to Dr Owens, early diagnosis of MS has a significant impact on patient outcomes. The presentation explained that the McDonald
Criteria, which breaks down diagnosis based on the number of attacks and MRI lesions, as the primary diagnostic tool.

Dr Owens’ presentation highlighted some of the upcoming specialty drugs in the pipeline for treating MS, including firategrast (GlaxoSmithKline) and Arzerra (ofatumumab; Novartis) both expected to get a MS indication in 2017. Looking beyond 2018, MS drugs include opicinumab, ameselimod, ozainmod, ibudilast, and siponimod. 

Dr Owens also addressed strategies for payer management of MS. He noted that there is currently not enough evidence to support a detailed MS treatment algorithm, and that the lack of guidelines is becoming more of an issue as more and more new treatments come to the market. He concluded by outlining the general principles for management of MS, including the need for plans to conduct their own assessment of the available research, establishing quality metrics to improve outcomes, use patient education, and to tackle medication adherence. —David Costill