Novel biologic agents for multiple sclerosis and their impact on managed care

Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system that is associated with progressive disability and cognitive dysfunction. Advance in our understanding of MS pathogenesis and DNA technology have led to the development of several novel biologic agents t target steps in the pathogenesis of the MS lesion. As these biologic agents become available, it will be critical to evaluate their efficacy, tolerability, and routes of administration relative to currently approved agents, to determine which therapies provide the greatest clinical benefit and economic value. Furthermore, the impact on coverage for infusible biologic agents has yet to be determined in light of the recent enactment of the Medicare Prescription Drug Improvement and Modernization Act of 2003. Experience with challenges encountered with utilization of biologic agents in the treatment of rheumatoid arthritis and psoriasis, and strategies developed to affect appropriate cost-effective treatment modalities may help guide the incorporation of novel biologic agents in the management of MS.