dangling carrots

Breaking news - in case you don't read the health section of your daily newspaper -

Provincal governments urged NOT to reimburse for promising new MS therapy!


I was made aware of this decision earlier this week while reading a free publication on MS that I receive in the mail (msdialogue is also available online at http://www.mswatch.ca/).

The article that I read provided a bit more information on the group behind the decision. The Canadian Expert Drug Advisory Committee (CDEAC) established the Common Drug Review (CDR) process in 2002. The CDEAC reports to the Canadian Agency for Drugs and Technologies in Health. The CDR assess the safety, effectiveness, and cost -effectiveness of new therapies compared with existing ones. The committee is comprised of physicians, pharmacologists, health economists and members of the public. Of the physicians on the committee, none are neurologists.

Here is a breakdown of what the various drugs cost per year:

$16 000 for glatiramer acetate (also known as Copaxone)
$18 000 - $22 000 for beta-interferons
$33 700 for natalizumab (also known as Tsyabri)

Some provinces MAY provide some reimbursement if a doctor submits a special request.

Ok - so what do I think of all this?

I am at the beginning of my journey, and I have already ruled out one treatment. What is the sense in having a list of effective drugs that aren't covered by the government? It isn't as if the patient goes to the pharmacy, buys the drug and then sends a bill to the government, demanding re-reimbursement.

A doctor must first prescribe the drug, and then an application is submitted to the provincial government for partial funding. Not every patient is going to be on Tsyabri - it isn't like buying candy. The doctor has to believe that it is the best treatment for that patient, and in some cases, it may be the last treatment to try. No drug will halt this disease in it's path - we only hope to slow the progression. How can that be denied?

Health Canada approved Tsyabri based on positive results from two clinical trials. "The largest study, the AFFIRM clinical trial, involved 942 people with relapsing-remitting MS and evaluated the effect of Tysabri on the rate of clinical relapses and the progression of disability. The study found Tysabri reduced the rate of clinical relapse by 68 percent compared to placebo and the risk of disability progression was reduced by 42 percent as a primary end point compared to placebo. It also had a statistically significant reduction in the number and size of active brain lesions identified on magnetic resonance imaging (MRI) scans. "*

Glatiramer Acetate and Beta-Interferons can reduce the rate of clinical relapse by about 30%.

Two tiered health care - dangling carrots for the wealthy.



*This was taken from the Multiple Sclerosis Society of Canada website. See the full article here:



Anonymous said...
October 15, 2007 at 5:56 p.m.

Those carrots are golden.
I have trouble with Federal committees deciding whether a Province will pay for a drug. Have I misunderstood?
The neurologists aren't on the committee because they are too busy trying to figure out which bandaid to put on their MS patients.
Mom XX

Emms said...
October 15, 2007 at 6:23 p.m.

Yes, I believe that the CDEAC is a Federal committee - but I will look further to see if it is true.

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