Disease management programs for patients with multiple sclerosis improve outcomes and adherence, reduce disability, and contains cost, but there are not enough of them in existence. That’s the main finding of a study by the National Multiple Sclerosis Society and Teva Neuroscience in which 82 managed care executives were polled. (Teva Neuroscience is the manufacturer of glatiramer acetate, trade name Copaxone, a treatment for MS.) The study also found that:
Only 8 percent of plans have a mature disease management program for MS in place, and less than half have a partially developed disease management program for MS.
Of the MCOs that participated in the research, 90 percent currently contract with specialty pharmacies and 79 percent indicated that their members with MS will be required or encouraged to use a specialty pharmacy to obtain injectable drugs within the next two years.
Insurers tightly control — through prior authorizations or moratoriums — new molecular entities, especially those in competitive categories or those whose use is largely off label.