Out of Control: MS Drug Costs

People using any of the Multiple Sclerosis Disease Modifying Treatments (DMTs) have been talking about this for some time. I wrote about it in my article At What Cost Can We Continue to Treat MS in September 2014.

This should come as no surprise, but in case you don’t already know, the costs of MS Drugs are escalating out of control and show no signs of slowing, let alone stopping or dropping. This is currently a big headline getting a lot of attention thanks to a study that was presented at the 2015 American Academy of Neurology  convention.

The study comes from a group of academic researchers at Oregon State University, and they came to the same obvious conclusion I reached when comparing insurance EOBs and other tidbits and receipts for services.

Not only have the costs of the disease modifying treatments continued to increase since they became available over 20 years ago, they have done so at a rate of over 700%, according to this latest review which only goes through 2013. Their report, The cost of multiple sclerosis drugs in the US and the pharmaceutical industry: Too big to fail?, takes a critical look at this increase but is also introspective about the responsibility of the medical profession to speak up for change.

“The driving force behind this study was our experience that the high cost of MS drugs interferes with our ability to take good care of our patients. We decided to shine a light on this growing problem so that those of us who care for patients with chronic illness can work together and advocate for changes to drug pricing mechanisms,” said Dr. Ruth H. Whitham, co-author of the study, a professor of neurology in the OHSU School of Medicine, and co-founder of the Multiple Sclerosis Center at OHSU, in the official news release.

The authors point out the pricing of MS drugs is contrary to what should normally happen in a market. Over time, the cost should go down. When more competition is added to the market, the costs should go down. When the development and research expenditures are paid off, the costs should go down.

Instead, the opposite has happened and these drugs have done nothing but gone up in price and there is not a single DMT that costs less than $50,000 per year. The price increase has been well in excess of normal inflation over those years, even when they are compared to similar biological drugs which are among the most expensive to manufacture.

How this out of control pricing has happened is the pressing question. Part of the problem, according to the authors, is the industry is unregulated as far as pricing, and how those prices are set is not transparent. This problem exists with other specialty diseases too, and is not exclusive just to the 12 approved multiple sclerosis DMTs. “Some in the medical community have begun to question the ethics of our current free-market drug pricing system and to acknowledge that exorbitant pricing for drugs is a major burden on our already stressed health care system” according to the release.

The Bloomberg Business Report carried a story about this report, and in How Much Would You Pay for an Old Drug? If You Have MS, a Fortune, they also condemn the pricing structure for these drugs. This story is worth a look, if only for the graphs and the money/business angle that completes the perspective of the financial gains realized by the pharmaceutical companies.

The OHSU study does not offer a suggestion on how to stop this escalation of treatment costs, but they do issue a challenge at the end of their study that their peers who treat MS should become familiar with what the drugs cost and speak up about these increases.

The authors conclude “...the unbridled rise in the cost of MS drugs has resulted in large profit margins and the creation of an industry ‘too big to fail.’ It is time for neurologists to begin a national conversation about unsustainable and suffocating drug costs for people with MS—otherwise we are failing our patients and society”

To these researchers I say ‘thank you’ for acknowledging and urging others to act on what people living with multiple sclerosis have been saying for years – people are drowning in the costs of their MS treatment and we need relief from the escalating costs. Dare we hope they have started a conversation in the medical profession that will gain momentum and bring about change?

Wishing you well,


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