Contributions
Abstract: 54
Type: Oral
Multiple Sclerosis (MS) presence in Latin America (LATAM) generates considerable socioeconomic impact. Elevated costs involved in diagnosis acquisition, medication and long-term care finds developing-country health systems unprepared to include MS within their budgetary responsibilities. Although, oral and IV steroids are universally utilized for acute relapse management, access to symptomatic medication and rehabilitation facilities remains limited. Disease-modifying therapies (DMTs) are not readily available in most countries. Third-party health insurance companies are scarce, and in most LATAM countries national health care is provided by the State through public hospitals and Social Security Institutes (SSI). However, budgetary restrictions in the region curtail adequate public health care for MS patients. Thus, although regional Regulatory Authorities have approved use of some MS medications, costs are not covered by local health systems. Furthermore, SSI health care coverage reaches only a fraction of the community, namely active economic groups: i.e. employees and their immediate family. In addition, SSI or HMOs in many LATAM countries provide generics or biosimilar compounds and not original brands, arguing lower prices. However, in most cases generic and biosimilar drug prices are not significantly lower than originals, with the added problem that many of these compounds lack adequate safety and efficacy studies.
A significant numbers of patients discontinue treatment after one year. In addition to tolerability issues and perception of lack of efficacy, which are common worldwide, patients frequently abandon treatment in LATAM because of red tape and bureaucracy or drug interchangeability problems. Finally, LATAM populations are rarely included in clinical trials. Information on pharmacogenomic responses to DMTs in these populations is therefore lacking.
Clearly, access to medication, as well as to rehabilitation and disability benefits vary markedly between countries. Fair access to DMT, issues related to treatment adherence, health systems, uncertainty about biosimilars and generic compounds are only some of the obstacles yet to be overcome, in order to improve MS patient management in LATAM.
Disclosure: JC is a board member of Merck-Serono Argentina, Novartis Argentina, Genzyme LATAM,Genzyem global, Biogen-Idec LATAM, and Merck-Serono LATAM. Dr. Correale has received reimbursement for developing educational presentations for Merck-Serono Argentina, Merck-Serono LATAM, Biogen-Idec Argentina, Genzyme Argentina, Novartis Argentina, Novartis LATAM, Novartis Global, and TEVA Argentina as well as professional travel/accommodations stipends.
Abstract: 54
Type: Oral
Multiple Sclerosis (MS) presence in Latin America (LATAM) generates considerable socioeconomic impact. Elevated costs involved in diagnosis acquisition, medication and long-term care finds developing-country health systems unprepared to include MS within their budgetary responsibilities. Although, oral and IV steroids are universally utilized for acute relapse management, access to symptomatic medication and rehabilitation facilities remains limited. Disease-modifying therapies (DMTs) are not readily available in most countries. Third-party health insurance companies are scarce, and in most LATAM countries national health care is provided by the State through public hospitals and Social Security Institutes (SSI). However, budgetary restrictions in the region curtail adequate public health care for MS patients. Thus, although regional Regulatory Authorities have approved use of some MS medications, costs are not covered by local health systems. Furthermore, SSI health care coverage reaches only a fraction of the community, namely active economic groups: i.e. employees and their immediate family. In addition, SSI or HMOs in many LATAM countries provide generics or biosimilar compounds and not original brands, arguing lower prices. However, in most cases generic and biosimilar drug prices are not significantly lower than originals, with the added problem that many of these compounds lack adequate safety and efficacy studies.
A significant numbers of patients discontinue treatment after one year. In addition to tolerability issues and perception of lack of efficacy, which are common worldwide, patients frequently abandon treatment in LATAM because of red tape and bureaucracy or drug interchangeability problems. Finally, LATAM populations are rarely included in clinical trials. Information on pharmacogenomic responses to DMTs in these populations is therefore lacking.
Clearly, access to medication, as well as to rehabilitation and disability benefits vary markedly between countries. Fair access to DMT, issues related to treatment adherence, health systems, uncertainty about biosimilars and generic compounds are only some of the obstacles yet to be overcome, in order to improve MS patient management in LATAM.
Disclosure: JC is a board member of Merck-Serono Argentina, Novartis Argentina, Genzyme LATAM,Genzyem global, Biogen-Idec LATAM, and Merck-Serono LATAM. Dr. Correale has received reimbursement for developing educational presentations for Merck-Serono Argentina, Merck-Serono LATAM, Biogen-Idec Argentina, Genzyme Argentina, Novartis Argentina, Novartis LATAM, Novartis Global, and TEVA Argentina as well as professional travel/accommodations stipends.