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Cost-Effective Options Are Making Treatment More Accessible for Canadians with MS

nicky nash
nicky nash
Nicky Nash shot by Neil Zeller

Affordable MS medications are contributing to the sustainability of the health care system while providing effective therapy.

Nicky Nash, a new mom from Calgary, was experiencing periods of numbness in her arm, leg, and face. She especially noticed it during times of stress. Over a period of about 18 months, Nash saw her family doctor, went for blood tests and a CT scan, and visited the emergency room several times, but doctors couldn’t find anything wrong. After her family doctor sent her for an MRI, she got a call the next day with a referral to the multiple sclerosis (MS) clinic. In August 2019, Nash was diagnosed with relapsing-remitting multiple sclerosis (RRMS).

A chronic autoimmune disease of the central nervous system, MS can affect vision, memory, balance, and mobility. RRMS is characterized by relapses in which new or recurrent neurological symptoms flare up for days to months and are followed by periods of recovery, during which many functions return. About 85 percent of people with MS are diagnosed with this form of the disease.

Ongoing progress in developing new treatments

There’s no cure for MS, but there has been much progress in developing medications to treat it. For example, disease-modifying therapies target some aspects of the inflammatory process of MS and can reduce the frequency and severity of relapses, reduce the number of new lesions in the brain and spinal cord as seen on MRIs, and slow down disability. “Exciting research is ongoing to develop new and better treatments,” says Dr. Paul Marchetti, a neurologist at the St. Michael’s Hospital Multiple Sclerosis Clinic. “The growing number of treatments helps tailor selection to the patient’s specific needs and priorities.”

This personalized approach is one of the most important aspects of treatment, says Nash, who’s currently taking a subsequent entry non-biologic complex medication. “Everyone’s journey with MS is different and the treatment plan should take that into account,” she says.

Doctors are encouraging MS patients to take a more active role in their treatment plan and to regularly communicate with their doctor to form the best strategy. An individualized plan is important because symptoms may come and go, gradually worsen, and sometimes disappear. Treatments differ in how they’re taken and how often, and in what side effects they may cause. There are also differences in how different people respond to a treatment and one person’s response to a medication could change over time, in which case a switch in treatment plan should be considered.

The cost of treatment is a consideration for patients

Another consideration for patients is the cost of MS treatment. Although most medications are covered by insurance, they’re rarely covered fully. Subsequent entry non-biologic complex medications are changing the landscape, however. These less expensive medications significantly reduce the cost for patients.

“Recently, many patients have been asked to transition to subsequent entry medications from the original treatment. The reduced cost of these treatments is significant to health care budgets,” says Dr. Virginia Devonshire, a neurologist and Clinical Associate Professor at the Department of Medicine at the University of British Columbia, referring to a policy under the provincial drug plans in British Columbia, Alberta, Ontario, and Quebec.

The subsequent entry complex medications for MS aren’t precisely considered generics — or an exact copy of the original treatment. Though there’s a Health Canada standard to accommodate and to ensure treatment efficacy, Dr. Devonshire says that some people living with MS have had some anxiety around switching. “Most have done very well with their current therapy and are concerned that they might have side effects or a change in efficacy,” she says. But Dr. Devonshire says that she hasn’t yet seen any noticeable change in her patients’ disease activity after a switch. “If we can get the same treatment outcome at a lesser cost, this benefits us all. It saves taxpayers’ money that could go to areas of health care that are underfunded.”

Dr. Mark S. Freedman, a Professor of Neurology at the University of Ottawa and Director of the Multiple Sclerosis Research Unit at The Ottawa Hospital, says that he hasn’t observed any differences in his patients’ conditions after they’ve switched. He points to a study that found the subsequent entry complex medication had equivalent efficacy, safety, and tolerability in treating RRMS. “I think we’re assured that it’s just as effective,” he says.

Follow a treatment plan that’s right for you

Having more affordable treatments available in Canada means they’re more accessible, providing increased options to help patients live fulfilling lives. Nash is grateful to have a more cost-effective treatment, which helps improve her quality of life without having to worry about finances.

Since being diagnosed, Nash has learned as much as she can about MS and maintains open communication with her doctor to follow a treatment plan that feels right for her and her family. She advises other MS patients to take it day by day.

This article was made possible with support from Pendopharm.

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