The 2010 Government Supported Benefits 'Virtual' Summit
A unique web-based conference and series of accredited on-line self-learning programs focused on the impact of Heathcare reform on providers and patient care.
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The 2010 Government Supported Benefits 'Virtual' Summit |
A unique web-based conference and series of accredited on-line self-learning programs focused on the impact of Heathcare reform on providers and patient care. |
|
Multiple Sclerosis
Introduction
Multiple sclerosis (MS) is an acquired, inflammatory and immune mediated disorder of the central nervous system that affects 350,000-450,000 persons in the U.S. Disease Modifying Treatments (DMTs) for MS aim to reduce the frequency and severity of relapses, delay disability, and postpone the onset of the progressive phase of MS. Most agents are parenteral and self-administered. Recently, a physician-infused DMT and oral agents are entering the market.
The management of biologics, parenteral products, increased utilization of specialty pharmacy have all been listed as major health care challenges. Given the potential evolution of MS treatment landscape into orals; and the likelihood of a crowded MS marketplace, the value proposition of these options are likely to be evaluated and scrutinized more carefully by decision-makers. Healthcare providers need to become aware of new and developing treatments.
Existing Practice Gaps and Needs Analysis
During the first five years of immunomodulatory therapy, one to two out of every five patients with MS stops taking their prescribed therapy. 1,2 Evidence shows that one of the major determinants of how well a patient with MS adheres to therapy is the relationship the patient has with his or her healthcare provider;1 the degree to which a patient feels support from his or her provider is actually an independent predictor of adherence, according to a survey of patients with self-reported progressive forms of MS.3 The establishment of trust is dependent on the extent to which the patient feels the provider is being honest and open about prognosis, diagnosis, and treatment options. Additionally, examinations of adherence to medical therapy in general highlight the necessity of a patient’s understanding of their clinical circumstances, goals of therapy, and complexity of their medical regimen, necessitating a provider’s comprehension of the same. Logistical factors at play in the medical system, like high drug costs and difficulty in physically obtaining medications, also deter patients from optimal compliance with prescribed therapy.4 One other independent predictor of adherence to therapy is severity of disability.2,3 One study suggests that one out of two patients with MS who discontinue taking their immunomodulatory medication does so within the first two years of therapy, and that those with higher degrees of disability are particularly at risk.2 The study’s authors call for “close follow-up of these patients would be useful in avoiding early discontinuation of therapy.”2
Stated another way, the quality of the relationship a patient with MS has with his or her healthcare provider predicts adherence, which impacts outcomes. A high rate (20-40%) of self-initiated therapy discontinuation among patients indirectly illustrates that there is room for improvement in care – or that a practice gap exists. Moreover, a needs analysis based on the literature suggests that a range of barriers to care exist, and by raising knowledge of those barriers and of the MS disease state itself, physicians are better empowered to not only develop a more empathetic and stronger relationship with their patients, but they may also play a larger role in helping patients overcome those barriers.
This program has been designed to raise awareness of these barriers among healthcare providers so that they provide future care with an understanding of and sensitivity to existing challenges to the optimal medical care of MS.
Learning Objectives
The learning objectives for this program are to enable participants, at the conclusion of the program, to able to:
Understand MS symptoms, epidemiology, comorbidities, and costs,
Discuss treatment goals, existing and developmental parenteral and oral medications to treat MS, place of products in therapy as it relates to their value proposition based on Benefit/Risk as it relates to their efficacy, safety, tolerability and value profile
Become familiar with adherence to therapies, and likelihood of therapy to achieve treatment goals
Understand costs, reimbursement and the managed care budget impact of MS agents
References
1 Costello K, Kennedy P, Scanzillo J. Recognizing nonadherence in patients with multiple sclerosis and maintaining treatment adherence in the long term. Medscape J Med. 2008;10:225.
2 Río J, Porcel J, Téllez N, et al. fractors related with treatment adherence to interferon β and glatiramer acetate therapy in multiple sclerosis. Mult Scler. 2005;11:306-9.
3 Fraser C, Hadjimichael O, Vollmer T. Predictors of adherence to glatiramer acetate therapy in individuals with self-reported progressive forms of multiple sclerosis. J Neurosci Nurs. 2003;35:163-70.
4 Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 353:487-97.
Agenda
Disclosures and Introduction (2 minutes)
MS symptoms, epidemiology, and comorbidities (15 minutes)
Adherence to therapies, and likelihood of therapy to achieve treatment goals (10 minutes)
Costs, reimbursement and the managed care budget impact of MS agents (10 minutes)
References, Summary and Conclusions (3 min)