Thursday, February 3, 2011

Accessing New MS Medications in Tough Budget Times

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Yesterday, Barry Boardman, Ph.D presented the state’s economic outlook for the rest of year leading into state fiscal year 2012.. The good news is that tax revenues are better than expected, however a truer revenue picture will come in April.

For the last several years as revenues have declined, North Carolina has instituted some cost saving measures. The North Carolina General Assembly gave the Division of Medical Assistance the authority to establish a preferred drug list (PDL). Initially, all MS disease modifying drugs were considered preferred. However, once the first oral medication for MS was approved by the FDA, the PDL panel needed to review the Gilenya and symptom management drug Ampyra. In December, the National MS Society, NC Chapters sent a letter to the review panel requesting that equal access to all of the MS disease modifying medications. The Society “recognizes that the availability of Gilenya as the first oral MS treatment challenges MS clinicians, patients and insurers to consider when and whether a person with MS that is already on a disease modifying therapy should consider switching to a different treatment. The Society believes this decision should be made by a person living with MS in consultation with his or her physician.”

On Friday, January 28, Dr. Ugo Goetzl, chair of the Eastern North Carolina Chapter’s Clinical Advisory Committee, presented oral testimony to PDL panel. The panel took Dr. Goetzl’s expert testimony under heavy consideration and voted to allow physicians to prescribe Gilenya to their patients on Medicaid with prior approval should they experience a site reaction during their injection therapy. For more information on North Carolina Division of Medicaid Assistance’s preferred drug list, visit here:

If you are having trouble accessing new MS medications, contact the National MS Society for information and appeal assistance.
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