Author response: Neurologists and the economics of MS treatment: Lighting candles, not cursing the darkness

Dr. Otulana, Chief Medical Officer for Mallinckrodt Pharmaceuticals, which produces H.P. Acthar Gel, claims that Acthar is cost-effective in a response to our editorial.¹ To support this statement, Dr. Otulana references a study paid for by Mallinckrodt that is not a cost-effectiveness analysis.² The cited study compares costs of health care services delivered to patients who received Acthar compared with a group that received either plasmapheresis or IV immunoglobulins (IVIg) for multiple sclerosis (MS) relapse.³ While there was a modest difference in total cost of care over 12 and 24 months after treatment between the 2 groups, the article by Gold et al.² revealed that those receiving Acthar had much higher medication costs over 12 months compared with the plasmapheresis/IVIg group (mean cost of $87,200 vs $12,300). The high medication costs may reflect the expense of Acthar. The current average acquisition price of a 5-mL vial of Acthar containing 80 IU/mL of repository corticotropin is $34,000.³ Patients receive 80 IU of Acthar once a day for 5–15 days,⁴ costing a stunning and unjustified $34,000–$102,000. I stand by our editorial, in which we state that neurologists "should not be using repository corticotropin to treat MS relapses given its high cost."¹

from # All Medicine by Alexandros G. Sfakianakis via alkiviadis.1961 on Inoreader http://ift.tt/2vmP9Zh