Highlights
- •Health services must ready themselves to provide DMTs for people with progressive MS.
- •Estimated eligibility rates are helpful to plan resource requirements.
- •Many prevalent cases of progressive MS will require clinical and radiological re-evaluation.
- •The cost of DMT provision will include both drug and service components.
Abstract
Background
As disease-modifying therapies become approved for primary progressive multiple sclerosis
(PPMS), services must be aligned in readiness.
Methods
In this paper we use population and clinic-based data to estimate eligibility rates
for ocrelizumab, and the extent of additional service requirements necessary to ensure
its widespread introduction in PPMS.
Results
Overall population estimates for the incidence and prevalence of people with PPMS
who are eligible for ocrelizumab are 1.6 and 4.2 per 100,000 respectively. The majority
(87%) of incident cases of PPMS satisfied clinical eligibility criteria for ocrelizumab
but lacked radiological evidence of disease activity due to a historical tendency
not to routinely monitor using MRI in this group. The majority of prevalent patients
did not satisfy clinical eligibility criteria for ocrelizumab, mainly because of advanced
disease duration or disability.
Conclusions
These findings illustrate the fact that there has been a tendency for people with
PPMS not to receive routine clinical and radiological monitoring. Additional planning
or resources will be required to facilitate contemporary disease re-evaluation and
surveillance at a population level.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Multiple Sclerosis and Related DisordersAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Modelling the natural history of primary progressive multiple sclerosis.J. Neursol. Neurosurg. Psychiatry. 2015; 86: 13-19
StatsWales [Internet]. [cited 2006 Jul 20]. Available from: https://statswales.gov.wales/Catalogue/Population-and-Migration/Population/Estimates/Local-Health-Boards/populationestimates-by-welshhealthboard-year.
- New diagnostic criteria for multiple sclerosis: guidelines for research protocols.Ann. Neurol. 1983; 13 (Mar): 227-231
- Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald criteria.Ann. Neurol. 2005; 58 (Dec): 840-846
- Recommended diagnostic criteria for multiple sclerosis: guidelines from the international panel on the diagnosis of multiple sclerosis.Ann. Neurol. 2001; 50: 121-127
- Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria.Ann. Neurol. 2011; 69 (InternetFebAvailable from): 292-302https://doi.org/10.1002/ana.22366
- Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria.Lancet Neurol. 2018; (InternetJan 8Available from)https://doi.org/10.1016/S1474-4422(17)30470-2
Article info
Publication history
Published online: April 15, 2020
Accepted:
March 13,
2020
Received in revised form:
January 27,
2020
Received:
September 24,
2019
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
