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Abstract Details

Â鶹´«Ã½Ó³»­ 2018 Treatment Guidelines: US Payers’ Perspective
Multiple Sclerosis
P12 - Poster Session 12 (12:00 PM-1:00 PM)
9-001
Assess the impact of the 2018 Â鶹´«Ã½Ó³»­ (Â鶹´«Ã½Ó³»­) treatment guidelines on payer decisions regarding MS treatment in the US.
In 2018, Â鶹´«Ã½Ó³»­ published updated guidelines on the use of disease-modifying therapies (DMTs) in MS patients.
Eight managed care advisors participated in an expert panel sponsored by Sanofi to discuss the management of MS patients.
Payers frequently refer to clinical guidelines when developing formularies and prior authorization criteria for chronic diseases. However, the advisors noted the 2018 Â鶹´«Ã½Ó³»­ guidelines lack key information, limiting their impact on payer decision making. The panel highlighted that the guidelines would be more relevant to payers if they included DMT selection criteria based on clinical evidence, such as brain volume loss or number of lesions, and additional specific guidance on disease severity and treatment sequencing. Moreover, the guidelines lack payer-relevant discussion of cost-effectiveness to support comparative formulary decisions. Providing information on evolving measures, such as no evidence of disease activity rates or other suitable outcomes relative to DMT cost, would increase the utility of the guidelines. Lastly, the Â鶹´«Ã½Ó³»­ guidelines reference highly active disease (HAD) but do not provide a HAD definition. A greater detail regarding HAD definitions used in the studies supporting the committee’s recommendations for these patients would be helpful. The panel suggested to educate payers on HAD definitions within the guideline recommendations and educate prescribers on 2018 Â鶹´«Ã½Ó³»­ guidelines for starting or switching DMTs for patients with HAD.
The advisors anticipate the 2018 Â鶹´«Ã½Ó³»­ treatment guidelines for MS will not have a substantial impact on payer decisions regarding MS treatment in the US, as they are missing crucial and relevant information. Without additional information from expert organizations and clinical studies, drug costs and rebates will continue to direct formulary decision making.
Authors/Disclosures

PRESENTER 		No disclosure on file
No disclosure on file
No disclosure on file
Kevin Duhrkopf, PharmD (Sanofi) No disclosure on file
Louis Hudspeth No disclosure on file
No disclosure on file
Manuel Nunez, PharmD (Sanofi) No disclosure on file
Michael Raffaele No disclosure on file
Aaron L. Boster, MD (Ohiohealth) Dr. Boster has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for sanofi. Dr. Boster has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for roche. Dr. Boster has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for novartis. Dr. Boster has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. Dr. Boster has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Serono. The institution of Dr. Boster has received research support from Sanofi. The institution of Dr. Boster has received research support from Roche.