Tuesday, June 06, 2006

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

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2 comments:

Jaime said...

Very interesting! I wonder if this will have any baring on those patients who do not are not recommended to take the interferons because of certain health issues (i.e. liver disorders)? Should be interesting to see how all of this plays out!

I hope you are well.

Jaime

The Patient Connection said...

The Patient Connection would like to take this opportunity to invite you to participate in a new blog on Multiple Sclerosis. It would be great if you could do so as it will help us plan research into Multiple Sclerosis over the next few months.

http://www.thepatientconnections.com/blog.asp?uid=15


What it is:

The purpose of this blog is to help The Patient Connection find out more about living with Multiple Sclerosis and how it is treated, its effect on home and the environment.

Also, you may be aware that in the United Kingdom NICE, the Government's drug watchdog, has recommended against the prescription of one of the most effective drugs so far developed to treat Multiple Sclerosis. NICE has advised that the efficacy of Tysabri is not proven or that the cost is simply too high.
"In clinical trials, Tysabri has shown a significant reduction in relapse rates and a reduction in the risk of disability progression.”
What does this mean? People with MS could face the prospect of an improved quality of life, would have the chance of staying in work and be independent and not rely on State benefits –
Simon Gillespie said: "The UK is now alone in rejecting this drug. More than 10,000 people with MS in Ireland, Germany, the USA and elsewhere are already benefiting. But NICE has decided people with aggressive MS in the UK are simply not worth it."
What are your thoughts? How are you currently treated? Are you fortunate enough to have been prescribed this drug? Do you have to go abroad for your prescription and treatment? How are you currently treated? Have you changed your lifestyle? Do you get the right support from the State, employers, friends, family?

If you wish to participate in market research now or in the future you can join our research community The Patients’ Voice here

http://www.thepatientconnections.com/patients-voice/index.html


If you have any more questions please feel free to get in touch with me on Belinda.shale@thepatientconnections.com

Thanks for your help

Belinda
The Patient Connection