This month in Lancet Neurology, a Canadian research team reports there is a pre-clinical phase in MS. The study used health administration records from four Canadian provinces (British Columbia, Saskatchewan, Manitoba, and Nova Scotia). Due to the nature of the Canadian health-care system, these provinces have computerized health-care records on >99% of residents, including hospital discharges, physician billing, prescription on records, and dates of all medical visits – all records can be linked by a unique health-care number assigned to individuals. Using these records, medical histories for 14,428 MS cases and 72,059 controls were included for this study. They compared health-care utilization in the same five-year period prior MS diagnosis between cases and temporally matched controls.
Interestingly, five years before a MS diagnosis, the number of hospital admissions for people who eventually developed MS was 26% higher than controls, and this increased to 78% higher a year before MS diagnosis. A similar pattern was observed for physician billing (5 years before diagnosis: 24% higher in people with MS than controls; 1 year before diagnosis: 88% higher in people with MS than controls). There was also a substantial increase in the number of prescribed drug classes in people with MS compared to controls (5 years before diagnosis: 23% higher; 1 year before diagnosis: 49% higher). These results clearly demonstrate a pre-clinical stage for MS where subtle symptoms exist before clinically definitive symptoms (also known as a prodromal stage). With further research, we can explore these subtle symptoms and hopefully diagnose MS earlier and initiate therapeutics earlier, slowing the rate of progression of MS.
From: When do MS symptoms start? By Farren Briggs PhD, ScM; The Accelerated Care Project for Multiple Sclerosis
The journal Neurology has recently published a compelling report on a study conducted by a research team at Oregon State University and Oregon Health & Science University that examines the pricing trajectories in the US of disease modifying therapies over the last 20 year and assesses the influence of what appear to be unexplained rising prices.
Access to affordable, high quality healthcare is essential for people with MS to live their best lives. The evidence tells us that early and ongoing treatment with an MS disease modifying therapy is vitally important to controlling disease activity, delaying the accumulation of disability and protecting quality of life. However, today’s healthcare reality is that the high cost of these important therapies prevents full access to them.
The Society is deeply concerned by the rising costs of MS therapies and the negative impact that this has on individuals being able to access these treatments. People with MS must have full access to affordable health care. The Society is committed to bringing together all the stakeholders on this issue to find viable solutions to lower the overall costs of MS care and expand the medication formularies available to people with MS, which too are affected by the escalating prices.
While Society endeavors continue to advance on addressing policy and pricing issues, the Society focuses on helping to ensure that people with MS have access to the therapies they need by assisting them to tap into available options and assistance programs. Our work is grounded in our Access to High Quality Healthcare Principles, which are the foundation for all of our actions.
To establish these strategic principles, the Society convened a task force comprised of people with MS, family members, health policy experts and healthcare providers. The task force also listened to the concerns and thoughts of people with MS through extensive social media monitoring, surveys, and feedback opportunities. The principles were adopted by the Society’s National Board of Directors in November 2014.
We are currently working to understand the complexities of the healthcare system, the interrelationships and points of influence. We have explored data on the formulary restrictions, met with numerous potential partners on these issues and created an extensive database of legislation at both the state and federal levels designed to increase access to medications in order to determine the best path forward for people with MS.