By February 2014, European marketing authorizations were granted for three new disease-modifying therapies (DMTs) for the treatment of multiple sclerosis (MS)—Aubagio (Sanofi/Genzyme), Lemtrada (Sanofi/Genzyme/Bayer HealthCare), and Tecfidera (Biogen Idec). Together with forthcoming market entrants, which include oral and nonoral DMTs, reformulations, and new molecular entities, novel agents have the potential to overcome shortcomings in efficacy and/or delivery among current mainstays of treatment. However, while expanding therapeutic choice, these new options will also complicate treatment decision making in MS. This report will examine the factors that influence prescribing patterns for current DMTs across the EU5 (France, Germany, Italy, Spain, the United Kingdom), and explore how physicians and payers will grapple with the influx of potentially costly DMT alternatives, each offering a unique blend of benefits and risks, against a backdrop of increasingly stringent cost-containment measures and market access challenges.
Decision Resources’ European Physician & Payer Forum report “A New Era for Multiple Sclerosis Disease-Modifying Therapy: EU5 Prescriber and Payer Perspectives on Current Mainstays, Recent Market Entrants, and Late-Stage Pipeline Products” explores the many clinical and funding/budgetary/reimbursement factors that affect the use and sales of MS DMTs. It draws on insights from 251 surveyed neurologists in the EU5 and from interviews with 15 European payers, all of whom have influence at a national or regional level. Interviewed payers include the following:
- France: Pharmacy director, member of hospital formulary committee, regional payer, and national adviser for the Haute Autorité de Santé (HAS); HAS-advising key opinion leader; pharmacy director, member of hospital formulary committee, and advisor to the HAS.
- Germany: National-level expert in evaluation of public healthcare and quality control, director of a sickness fund; head of Drug Division of State Doctor’s Association and member of the Gemeinsamer Bundesausschuß der Ärzte, Zahnärzte, Krankenhäuser und Krankenkassen (G-BA; Joint Federal Committee of Physicians, Dentists, Hospitals, and Health Insurance Funds); member of the Drug Commission of the German Medical Association.
- Italy: Prontuario terapeutico ospedaliero (PTO) and prontuario terapeutico ospedaliero regionale (PTOR) member; PTO and PTOR member, advisor to Agenzia Italiana del Farmaco (AIFA); physician and Ex-AIFA member.
- Spain: Hospital/local/regional formulary committee members and pharmacy directors; national and regional payer, member of Grupo de Evaluación de Novedades, Estandarización e Investigación en Selección de Medicamentos (GENESIS).
- United Kingdom: Pharmacy director; Clinical Commissioning Group (CCG) hospital budget holder, and member of the regional drugs and therapeutics committee; pharmacy director; CCG hospital budget holder; advisor to the National Health Service (NHS); pharmacy director and NHS advisor.