Practices of US health insurance companies concerning MS therapies interfere with shared decision-making and harm patients

Dennis Bourdette, Daniel M. Hartung, Ruth Whitham

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

The US Food and Drug Administration has registered 13 multiple sclerosis (MS) disease-modifying therapies (DMTs). The medications are not interchangeable as they vary in route of administration, efficacy, and safety profile. Selecting the appropriate MS DMT for individual patients requires shared decision-making between patients and neurologists. To reduce costs, insurance companies acting through pharmacy benefit companies restrict access to MS DMTs through tiered coverage and other regulations. We discuss how policies established by insurance companies that limit access to MS DMTs interfere with the process of shared decision-making and harm patients. We present potential actions that neurologists can take to change how insurance companies manage MS DMTs.

Original languageEnglish (US)
Pages (from-to)177-182
Number of pages6
JournalNeurology: Clinical Practice
Volume6
Issue number2
DOIs
StatePublished - Apr 1 2016

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Patient Harm
Health Insurance
Multiple Sclerosis
Decision Making
Insurance
Therapeutics
United States Food and Drug Administration
Action Potentials
Safety
Costs and Cost Analysis

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

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abstract = "The US Food and Drug Administration has registered 13 multiple sclerosis (MS) disease-modifying therapies (DMTs). The medications are not interchangeable as they vary in route of administration, efficacy, and safety profile. Selecting the appropriate MS DMT for individual patients requires shared decision-making between patients and neurologists. To reduce costs, insurance companies acting through pharmacy benefit companies restrict access to MS DMTs through tiered coverage and other regulations. We discuss how policies established by insurance companies that limit access to MS DMTs interfere with the process of shared decision-making and harm patients. We present potential actions that neurologists can take to change how insurance companies manage MS DMTs.",
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