Accessing Disease-Modifying Therapies for Multiple Sclerosis: A Pan-Canadian Analysis

The Conference Board of Canada, 48 pages, December 3, 2020
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Disease-modifying therapies (DMTs) slow down brain lesions and ease relapses in multiple sclerosis patients—but why can’t Canadians easily access them? This primer examines DMTs’ costs, barriers, policies, and opportunities.

Document Highlights

  • Disease-modifying therapies (DMTs) can reduce the frequency and severity of relapses and slow the progression of disability and new brain lesions in multiple sclerosis (MS) patients.
  • DMTs’ use changed significantly over the past decade, thanks to new, higher-efficacy drugs.
  • DMT claims grew by half between 2010–18. Reimbursement costs also rose, from $386.9 million in 2010 to $607 million in 2018.
  • Over half of DMTs are claimed through private drug plans. Seven per cent are paid for out-of-pocket. In 2018, this represented $39.3 million in spending for individuals and their families.
  • Families affected by MS face a greater financial burden than the average Canadian household. And out-of-pocket costs vary by treatment, province, and drug coverage.
  • Public access to new, innovative DMTs lags behind private drug coverage access.
  • Timely, affordable, and equitable access to DMTs will lead to better outcomes. Health systems and society at large also stand to gain.

Table of Contents

Highlights

Multiple sclerosis in Canada

Accessing prescription drugs: challenges faced by Canadians

Utilization and cost of DMTs in Canada

Innovative medications

Symptom management and costs

Comparing the out-of-pocket burden of other conditions

Impact of COVID-19 on private drug coverage

An illustration: accessing DMTs within a changing treatment landscape

Economic impact of appropriate DMT use

Conclusion

Appendix A—Methodology

Appendix B—Definitions

Appendix C—Disease-modifying therapies for multiple sclerosis treatment

Appendix D—Provincial drug plans for people living with multiple sclerosis

Appendix E—Out-of-pocket spending case study

Appendix F—Bibliography

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