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Neurology. 2016 Oct 11;87(15):1617-1622. Epub 2016 Sep 2.

Reducing costs while enhancing quality of care in MS.

Author information

1
From the Department of Neurology (I.K.), NYU Multiple Sclerosis Care Center, NYU School of Medicine, New York, NY; Department of Neurology (J.R.C.), University of Colorado School of Medicine; and Rocky Mountain MS Center at University of Colorado (J.R.C.), Aurora. ilya.kister@nyumc.org.
2
From the Department of Neurology (I.K.), NYU Multiple Sclerosis Care Center, NYU School of Medicine, New York, NY; Department of Neurology (J.R.C.), University of Colorado School of Medicine; and Rocky Mountain MS Center at University of Colorado (J.R.C.), Aurora.

Abstract

The rapid escalation in prices of disease-modifying therapies (DMTs) for multiple sclerosis (MS) over the past decade has resulted in a dramatic overall increase in the costs of MS-related care. In this article, we outline various approaches whereby neurologists can contribute to responsible cost containment while maintaining, and even enhancing, the quality of MS care. The premise of the article is that clinicians are uniquely positioned to introduce innovative management strategies that are both medically sound and cost-efficient. We describe our "top 5" recommendations, including strategies for customizing relapse treatment; developing alternative dosing schedules for Food and Drug Administration-approved MS DMTs; using off-label therapies for relapse suppression; and limiting the use of DMTs to those who clearly fulfill diagnostic criteria, and who might benefit from continued use over time. These suggestions are well-grounded in the literature and our personal experience, but are not always supported with rigorous Class I evidence as yet. We advocate for neurologists to take a greater role in shaping clinical research agendas and helping to establish cost-effective approaches on a firm empiric basis.

PMID:
27590294
PMCID:
PMC5067542
DOI:
10.1212/WNL.0000000000003113
[Indexed for MEDLINE]
Free PMC Article

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