U.S. Payers’ Views on Expansion of Patient Access to Disease-Modifying Therapies (DMTs) for Multiple Sclerosis
ECTRIMS Online Library. Robertson D. Oct 26, 2017; 200456
Derrick Robertson
Derrick Robertson
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Abstract: P801

Type: Poster

Abstract Category: Therapy - disease modifying - 32 Others

Background: In the U.S., pharmacists and physicians in payer organizations play pivotal roles in making formulary decisions about DMTs for MS. However, patient access to the full range of DMTs is limited.
Objective: To assess the extent to which payer organizations provide access to the full range of MS DMTs and to identify MS-related practice barriers and education needs and outcomes among U.S. pharmacist and physician payers.
Methods: Surveys were administered to pharmacist and physician payers (n = 657) before and after they participated in 3 accredited continuing education (CE) programs: a symposium at a national conference and 2 national webinars. Held between 9/3/2016 and 4/5/2017, the CE programs focused on MS pathophysiology, DMT mechanisms of action, and recent research and clinical trial evidence on B-cell-targeted DMTs for relapsing and progressive MS. The survey items assessed knowledge, barriers, and competence in these areas. The impact of the CE program was assessed by comparing pre- and post-education response frequencies to survey items.
Results: On the pre-education survey, only 23% of participants reported that their payer organizations strongly facilitated patient access to the full range of approved DMTs for MS. Participants reported that, other than costs, their main challenges in MS patient management were lack of established guidelines (50%) and uncertainty about when to initiate and switch DMTs (36%). Only 12% of participants indicated a good or excellent understanding of the roles of B- and T-cells in MS pathogenesis. There were significant pre- to post-education increases in the proportions of participants who anticipated that the education would promote greater patient access to DMTs (+20%, p< .001); understood the roles of B-cells and T-cells in MS pathogenesis (+22%, p< .001); correctly identified relationships between CD20 and B-cell subsets (+18%, p< .001); and would recommended switching DMTs for patients with disability progression by EDSS (+19%, p< .001), lesion progression by MRI (+14%, p< .001), or to improve tolerability (+14%, p< .001) and adherence (+12%, p=.001).
Conclusion: Among U.S. payers, participation in a series of CE programs enhanced intentions to expand patient access to MS DMTs and improved understanding of MS pathophysiology and competence in decision-making regarding treatment for relapsing and progressive disease.
Derrick Robertson, MD: Consultant for Biogen, EMD Serono, Genentech, Genzyme, Novartis, Pfizer, Teva; Received Honoraria or Speaker's Fees from Acorda, Bio­gen, EMD Serono, Genentech, Genzyme, Mallinckrodt, Novartis, Pfizer, Teva; Received Research Grant Support from Actelion, Biogen, EMD Serono, Genentech, Genzyme, Mallinckrodt, MedImmune, Novartis, Sun Pharma.
Jacquelyn Bainbridge, PharmD, FCCP: Nothing to disclose.
Cherilyn Heggen-Peay, PhD: Nothing to disclose.
Tamar Sapir, PhD: Nothing to disclose.
Kathleen Moreo, RN, BSN, BHSA, CCM, Cm, CDMS: Nothing to disclose.
The educational program reported in this abstract was funded through an independent grant from Genentech. The supporter had no role in the study design, abstract preparation, or abstract submission.

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