Nevada Medicaid & access limit to MS DMD meds

[Ufrustrated2]

Nevada Medicaid is attempting to limit access to Multiple Sclerosis platform medications. There are currently 5 platform treatments for individuals with MS:

Avonex (IM qwk ),  Betaseron (sq qod),  Copaxone (sq daily),  Rebif (sq 3 x wk) and Betaferon (sq qod)

The committee is presenting to the Medicaid board on June 24th, with a recommendation to limit access to Copaxone only.

The MS communtiy may not be aware of this at this time and they need help to stop this limitation of meds.

All of these meds have flu like side effects, shot site reactions, and all require injection. Some MS patients are unable or unwilling to self inject and compliance with all of the medications is problematic. However, taking away the patient and doctor's ability to choose the right treatment is not in the patients best interest.

If you are in Nevada you may want to let this sink in and realize the ramifications of the proposal. Then write a letter to the Nevada Medicaid, at the least have them to allow Copaxone and one of the ferons. Some MS folks cannot take Copaxone, so what are they going to do??

[Lulu54]

I'm glad the PDL remains unchanged - there really does need to be options for everyone.  Hopefully this was just a big misunderstanding and wasn't under serious consideration.

Cool down and stay out of the desert heat, ok?

~Lu

[Ufrustrated2]

as of today after the meeting:

::paraphrased from a medical friend who was there today::

"
The Medicaid PDL (preferred drug list) will remain the same (Avonex, Betaserone, Copaxone, and Rebif), No Extavia, because it is the same drug as Betaserone, under another name. Also, the committee approved Ampyra for the PDL list.
"

i hear many MSers showed up. i went, even had a google map, drove around the area,  and still couldn't find the building. 110 degrees, i headed back home. i'm better underwater with directions and a compass!

i'll email you the agenda that was discussed today

[Ufrustrated2]

>>As for cost savings, aren't the others less expensive, by virtue of being given less often than copaxone?  

cannot comment to any accurate degree on that question. if all things are equal, then i would say "yes" to your question. but are all things equal in this context?

i have plans to make the meeting, at the least just to educate myself more on all this, and let you know.

i'm one of the [lucky??] ones as my copaxone cost is taken care of by the VA.  one might ask why then am i even putting this out there --- i was recently awarded SSD for MS and other spinal disease conditions and thus i guess i will be eligable for medicaid -- so, if the VA formulary doesn't carry some DMDs(just saying, i don't know), and for some reason want/need to be on another besides copaxone, then i have a vested interest.

and i'm protective of friends, and i now have a few in the ms community here.

i do wish there was a spell checker on here,

[Lulu54]

I'll be waiting to hear more of this story - I did find adverse reactions noted on the article - specifically on page 5.  Unfortunately they have this pdf locked down and I can't copy the relevant parts to here for easier reading.  

As for cost savings, aren't the others less expensive, by virtue of being given less often than copaxone?  I honestly don't know this answer.

later, L

[Ufrustrated2]

That is the research article provided to Nevada Medicaid and will be used during the committee meeting.

Our nurse at one of our MS support groups brings to our attention that the article skims over the Copaxone side effects and makes no mention of the Copaxone site reactions, but focuses on the liver concerns with all the others.

That is the concern. Taking into context the fiscal crisis in the state of NV there are program cuts continuing across the board for many services.

Grant you, the concern could be reactionary, but for those in our support groups who rely on the other DMDs, it may well be a valid reaction. We'll know more after the meeting.

One thing I found out by posting this, doens't look like anyone from NV is on this list! ;-)

We will get more infomation and i'll post it to this thread.

[Ufrustrated2]

i'll find out for you, wait one ...

pharma money? i wouldn't know but certainly possible. i have often wondered what their stranglehold could be on the VA if any

[Lulu54]

Nevermind - I found it.

https://nevada.fhsc.com/Downloads/provider/NVRx_DCR_20100624_Multiple_Sclerosis_Agents.pdf

Go to page 12 and read the SUMMARY.  I don't read this as only approving copaxone.

it says that Copaxone's studies seem to make it the preferred drug but it still said the final choice of the drug will be left to the prescriber's discretion.

I would be curious to know if perhaps there is some big pharma money behind an attempt to get MS patients concerned ????

[Lulu54]

Well that is sure interesting.  Do you have a source for this information that you can refer us to so we can read more and do some research into what the thinking is behind this recommendation?

If it comes about, that would be disastrous for many with MS.   -L