Aliza Ben-Zacharia Details Necessary Policies to Improve Affordability of MS Treatment

Stronger intervention by the government in controlling price, accessibility, and availability of MS treatment can drive innovation, said Aliza Ben-Zacharia, DNP, ANP, associate director at the Center for Nursing Research and Innovation at Mount Sinai.

Transcript

Are there any policies that you would like to see enacted that would help improve affordability of MS treatment for the patients you serve?

Absolutely, I think 1 of the policies is the government has to control the price of the medication. That's what you have in European countries and in other countries that you can really develop these new policies and really control the price of the medications. I don't think that pharmaceuticals will provide it for free, and that's not my goal, but I don't think that you can allow anything to be so expensive—the thousands and thousands of dollars of the price of medication, and in some other diseases more than $100,000. I think nobody can really afford these medications, and because of it, some of the insurance policies become more expensive. The main policy is that everyone in the United States with MS should have access to medication and should be treated for their lifetime on medication. If clinician decides that the patient needs a different medication, not the insurance 1; 2, that's another policy that's very painful for me–I will prescribe a medication and then the insurance will give me their whole spiel about tier 1, level 1, level 2, no patient has to be on this, then on this–who gave them the right to make decisions about what medication patients will go on?

They don't have the knowledge, they don't have the expertise, they don't look at the MRI of patients, they don't look at the clinical presentation of patients; but yet, they make a decision about what medication. I think a policy has to be done and developed about these insurance companies. It's so important, and really patients need access to these medications. Either they have a relapsing course or progressive course—children, adult, elderly–everyone should be entitled and given this medication to control their disease. So, I think those 2 policies about access and affordable, but really controlling the price of the medication is number 1. Number 2, making sure that it's available to all patients and really controlling insurance company a bit. Just really, I think the government needs to get involved with insurance companies. They have in the past with pre-existing conditions, which was excellent so everyone can get it; but nowadays, they really have to intervene and create the policy for insurance to not intervene with care of patient–they should not make that decision.