In the news: Will your HMO cover Tysabri?

So Tysabri is headed back to market. But will your HMO pay for it? A Reuters piece notes that FDA has recommended Tysabri for those who've already tried the CRAB drugs, so your HMO may well insist you give them a try first. Snip:

Health insurers have new grounds to limit its use because the FDA recommended that only patients who have failed other therapies -- such as Schering AG drug Betaseron or Copaxone, made by Teva Pharmaceutical Industries Ltd. -- can move to Tysabri.

"What the FDA did yesterday, they went against the recommendations of the (FDA) advisory committee which said it should be approved first line therapy, so absolutely they (insurers) will not allow it unless they failed standard therapy," said Andrea Witt, an analyst at Decision Resources, a market research firm.

Biogen said most companies covered Tysabri in some way before the withdrawal and has been lobbying insurers ahead of the pending comeback. Link

technorati tag: multiple sclerosis