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Current Treatments or Medications
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There have been a growing number of treatments or medications that are currently available
to treat multiple sclerosis (MS) since the introduction of the beta-Interferons (IFN-β) in
1993. There are presently over 20 disease-modifying drugs or therapies available to treat this
disease. What started as the ABC drugs has grown to over 8 that are given through an injection
either intramuscular (IM) or subcutaneously (SubQ). There are 4 drugs are given through an
intravenous (IV) infusion which includes Mitoxantrone, it's the only immunosuppressant drug in
the group and is mainly used as a chemotherapy. The remaining two IV drugs are immunomodulating.
The remaining are the growing list of oral drugs that have been approved by the U.S. Food and
Drug Administration (FDA).
Much of the immune response associated with MS occurs in the early stages of the disease.
Aggressive treatment with these medications as early as possible can lower the relapse rate
and slow the formation of new lesions.
One of the biggest issues is that many of the disease-modifying therapies (DMTs) that are
used to treat MS carry significant health risks. Selecting the therapy that is right for
you will depend on careful consideration of many factors, including duration and severity
of disease, effectiveness of previous MS treatments, other health issues, cost, and
child-bearing status.
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FDA Approved Disease-Modifying Agents |
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Injectable Medications
• Avonex®
(interferon beta-1a) Recombinant IFN-β1a
• Betaseron®
(interferon beta-1b) Recombinant IFN-β1b
• Copaxone®
(glatiramer acetate injection)
• Extavia®
(interferon beta-1b) Recombinant IFN-β1b
• Glatiramer Acetate Injection
(glatiramer acetate) generic equivalent of Copaxone
• Glatopa®
(glatiramer acetate) generic equivalent of Copaxone
• Kesimpta®
(ofatumumab)
• Plegridy®
(peginterferon beta-1a) Recombinant IFN-β1a
• Rebif®
(interferon beta-1a) Recombinant IFN-β1a
Oral Medications
• Aubagio®
(teriflunomide), a pyrimidine synthesis inhibitor
• Bafiertam™
(monomethyl fumarate)
• Dimethyl Fumarate
(dimethyl fumarate) generic equivalent of Tecfidera
• Gilenya®
(fingolimod) sphingosine 1-phosphate receptor modulator
• Mavenclad®
(cladribine)
• Mayzent®
(siponimod)
• Ponvory™
(ponesimod)
• Tecfidera®
(dimethyl fumarate)
• Vumerity®
(diroximel fumarate)
• Zeposia®
(ozanimod)
Infused Medications
• Lemtrada®
(alemtuzumab)
• Mitoxantrone®
(generic of former Novantrone)
• Ocrevus®
(ocrelizumab)
• Tysabri®
(natalizumab)
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Beta-interferons are naturally occurring antiviral proteins. It's felt that they are
deficient in those with MS and left vulnerable. The beta-Interferons are believed to
supplement the deficiency and basically calm things down. The current beta-interferons
are similar in that they attempt to put up a wall against the blood brain barrier. With
all therapeutic proteins, there is a potential for immunogenicity making the drug
basically non-effective.
Most patients taking interferons find they have flu-like symptoms including fever, chills,
sweating, muscle aches and tiredness after the medication is injected. Many of those taking
DMTs find, however, that the side effects at times feel worse than those of the actual
disease. For many patients, these symptoms will lessen or go away over time.
The non-interferons include Copaxone and Tysabri. Copaxone is a synthetic protein
that simulates myelin basic protein and is believed to change the way the immune
system reacts to MS by preventing harmful cells from developing and by stimulating
beneficial cells in your body. Tysabri is a humanized monoclonal antibody is thought
to work by binding to immune cells and interfering with their movement from the
bloodstream into the brain and spinal cord.
Tysabri is an adhesion-molecule inhibitor that prevents the movement of T and B cells
into the brain which reduces inflammatory immune reactions. Tysabri is generally
reserved for patients who see no results from or can't tolerate other types of
treatments due to the fact that it increases the risk of PML — a brain infection
that is usually fatal (refer to the section titled
Treatments - PML).
Tysabri is the one medication that tests for JC virus before starting treatment and while
on treatment to help identify people who are at a higher risk for PML. Talk to your
healthcare provider about the testing required while taking Tysabri.
Mitoxantrone (formerly known under the brand Novantrone) — This immunosuppressant
drug isn't specifically for treating stable forms of relapsing-remitting MS
(RRMS), but rather for when it worsens. It can be harmful to the heart and is
usually used only in those who have advanced stages of MS. It inserts itself into
DNA, decreasing cell division and protein production and has been shown to decrease
proliferation of damaging B cells, T cells, and macrophages, and decrease production
of damaging cytokines. Mitoxantrone is typically considered at the first indication
that a patient's RRMS is worsening or transitioning into secondary-progressive MS
(SPMS).
Corticosteroids — These are the most common and longest used treatment for MS,
corticosteroids reduce the inflammation that spikes during a relapse. Examples
include oral prednisone and intravenous methylprednisolone.
A bit of information that is remarkable is that the dosage quantity of the three
interferon's are noticeably small. The dosage is being measured in micrograms
(1000th of a gram), and this due to the strength of this type of medication. So
a yearly total of 1.56 mg (milligrams) is all that is needed for Avonex, 45.5 mg
for Betaseron, and 6.86 mg for Rebif. Considering a single "baby" aspirin is 81
mg, and compare that to the yearly dose of these interferons, and there strength
becomes obvious.
It's important to note that some patients using interferon medications have
become very depressed or had thoughts of suicide. Call your doctor immediately
and talk to them about stopping the use of any medication if you have symptoms
of depression (sadness, crying, loss of interest in things you once liked) or if
you have any thoughts of hurting yourself.
The reason that these drugs are given at the frequency and amounts listed below,
is the same as any medication. It's important to maintain a constant level of
the medication in your system for a length of time that it can remain effective.
Too much at one time or given too frequently can have serious side effects as
with any medication. If too little is given or not frequently enough, then there
may be no benefit at all.
The main task for these drugs in very basic terms is that they place a barrier
of protection up around the patient's brain and spinal cord so their own immune
system can't attack the myelin coating around the nerves. These drugs have to be
smart in that they have to distinguish between what your immune system sends in
and then make a choice of either letting it pass to fight something else or
stopping it because it fits the profile of the enemy.
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Antibodies are proteins of the immune system that arise in response to foreign
substances, including viruses and bacteria. A neutralizing antibody (NAb) is an
antibody that defends a cell from an antigen or infectious body by neutralizing
any effect it has biologically. Once developed, they will block or neutralize the
biological effects of a medications protein or polypeptide. When this occurs, the
effects of a medication will lessen depending on the number of NAbs that are present.
The group of interferons (IFN-β) are of greatest concern to develop a form of
antibody to the injected protein. This is NAb because it interferes with or
neutralizes biological properties of the interferon. There is no convincing
evidence at this time that antibodies that develop in people taking glatiramer
acetate have any clinical significance.
Clinical trials have shown that immunogenicity of the IFN-β group along with
NAbs will reduce the clinical efficacy or effectiveness of these medications. If
and/or when any NAbs are detected through occasional blood tests, then a specific IFN-β
treatment typically will stop and be switched to a different IFN-β medication.
This adds to the need for careful monitoring of any DMT given to MS patients and
the need for a "plan B" if the current treatment fails. NAbs are just one of
many reasons a DMT must be modified for changed all together.
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The majority of drugs that are on the market today are made by synthesizing chemical
ingredients. These drugs in the most basic way, contain a bit of this and a bit of
that, with a stronger version containing more of this and less of that. Once the
chemicals are fully understood as well as the associated physical reactions to
those chemicals, it becomes as easy as mixing, packaging, and selling. The actual
costs over time for these types of drugs should reduce once the research and
development (R&D) are gone, but the reality of this is questionable.
The current DMTs costs are similar in that there are still the R&D costs that
must be recovered, but these drugs aren't based on chemicals, rather they are
"biological" based. They are made by using living cells which adds a significant
cost to these drugs. A biological based therapy is a treatment designed to
stimulate or restore the ability of the body's immune system to fight infection
and disease. Biological therapy is also called biotherapy or immunotherapy. Over
time the R&D costs should be paid off and manufacturing should remain the
largest cost.
As other DMTs have been introduced since 1993, the average price for them all
has slowly risen and not dropped. The cost for patients with MS is now so high
some people stop or never even start therapy. Insurance companies typically
assign these drugs to the tier with the highest co-pays, and government programs
try various ways to limit their use.
At this time, patents giving market exclusivity are ending for the first
generation of MS drugs, but competition hasn't appeared. It turns out there is
another problem. The FDA has no guidelines for approving "look-a-like" or "follow-on"
biologicals. The living cells that produce these special drugs are themselves
inventions and as such are protected as "proprietary" by their original developers.
A generic follow-on version of Betaseron or Avonex, the first two approved DMTs,
will be a cousin, not a twin sister, of the original. This raises important issues
for the FDA to consider.
The U.S. market has been slow to move unlike the European markets which now
provides an interesting advantage. European countries have already established
workable testing and approval pathways. Generic follow-ons taken for other
diseases are being prescribed and used in Europe without any loss of safety or
power.
Developers of the original innovative biological drugs want their data to remain
exclusive, extending their marketplace protection so they may limit the risks
they take in the long run-up to FDA clearance. While there are varying views on
how long that period should be, the National MS Society (NMSS) believes that
legislation should focus on providing a period of exclusivity that rewards
innovation, while providing a pathway for efficient approval.
"We have been told that follow-on biologics could lower retail costs by 25% in
the first round with greater savings to come as manufacturers gain market share
and experience," David Chatel of the NMSS has said. "We know how important it
will be for people living with MS to see the cost of their drug therapy reduced.
At the same time, we believe it is essential to include a fair period of market
protection for the companies that provide innovative treatments for MS, in order
to keep new drugs coming into the pipeline."
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Disease Modifying Medications Detailed Information
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For detailed information, press all or
individual to expand and/or collapse:
Injectable Medications:
Avonex
Recombinant IFN-β1a
This medication is taken by injection.
Generic Available: No
Description
Avonex® is a medication manufactured by a biotechnological process
from one of the naturally-occurring interferons (a type of protein).
It is made up of exactly the same amino acids (major components of proteins)
as the interferon beta found in the human body. In controlled clinical trials
in relapsing MS, those taking the medication had a reduced risk of disability
progression, experienced fewer exacerbations, and showed a reduction in number
and size of active lesions in the brain (as shown on MRI) when compared with
the group taking a placebo. In a subsequent study of patients who had
experienced a single demyelinating event in the optic nerve, spinal cord, or
brainstem, and had lesions typical of MS on brain MRI, Avonex significantly
delayed the time to a second exacerbation, and thus to a clinically definite
diagnosis of MS.
Avonex is approved by the U.S. Food and Drug Administration (FDA) for the
treatment of relapsing forms of multiple sclerosis, which include clinically
isolated syndrome, relapsing-remitting disease (RRMS) and active secondary
progressive disease (SPMS with relapses).
Click here to read the FDA Prescribing Information for healthcare professionals.
Click here to read the FDA Medication Guide for patients.
Support
AVONEX SUPPORT PROGRAM
1-800-456-2255
www.avonex.com
www.abovems.com
Financial Assistance Program
Above MS™
1-800-456-2255
www.abovems.com
Betaseron
Recombinant IFN-β1b
This medication is taken by injection.
Generic Available: No
Description
Betaseron® and Extavia® are brand names for interferon beta 1b, a medication
manufactured by a biotechnological process from one of the naturally occurring
interferons (a type of protein).
Betaseron and Extavia are approved by the U.S. Food and Drug Administration
(FDA) for the treatment of relapsing forms of multiple sclerosis to include clinically
isolated syndrome, relapsing remitting disease, and active secondary progressive
disease, in adults.
Click here to read the FDA Prescribing Information for Betaseron.
Click here to read the FDA Medication Guide for patients.
Support
BETAPLUS® Support Program
1-844-788-1470
www.betaseron.com/betaplus-support-program/
Financial Assistance Program
BETAPLUS® Financial Support
1-844-788-1470
www.betaseron.com/betaplus-support-program/financial-support/
Copaxone
Glatiramer acetate
This medication is taken by injection.
Generic Available: Yes
Description
Glatiramer acetate is a synthetic protein that simulates myelin basic protein, a
component of the myelin that insulates nerve fibers in the brain and spinal cord.
This drug seems to block myelin-damaging T-cells through a mechanism that is not
completely understood.
Glatiramer acetate is approved by the U.S. Food and Drug Administration (FDA)
for relapsing forms of multiple sclerosis, which include clinically isolated syndrome,
relapsing-remitting disease (RRMS) and active secondary progressive disease (SPMS with relapses).
In January, 2014, the FDA approved a new 40 mg/mL dose of this medication, injected
three times per week, which is double the standard 20 mg/mL dose that is injected daily.
The approval was based on benefits and safety demonstrated in a one-year phase III trial
comparing the higher, less-frequent dose of the medication with placebo. The standard
dosing option continues to be available.
Click here to read the FDA Prescribing Information for healthcare professionals.
To read the Patient Information, go to the FDA Prescribing Information on the above link and scroll down to page 5.
Support
COPAXONE SUPPORT PROGRAM
Shared Solutions®
1-800-887-8100
www.copaxone.com
www.sharedsolutions.com
Financial Assistance Program
Shared Solutions®
1-800-887-8100
www.sharedsolutions.com
Extavia
Recombinant IFN-β1b
This medication is taken by injection.
Generic Available: No
Description
Extavia® and Betaseron® are brand names for interferon beta 1b, a medication
manufactured by a biotechnological process from one of the naturally occurring
interferons (a type of protein).
Betaseron and Extavia are approved by the U.S. Food and Drug Administration
(FDA) for the treatment of relapsing forms of multiple sclerosis to include
clinically isolated syndrome, relapsing remitting disease, and active secondary
progressive disease, in adults.
Click here to read the Extavia Prescribing Information for healthcare professionals.
Click here to read the Extavia Medication Guide for patients.
Support
Extavia Go Program™
1-866-398-2842
www.extavia.com
Financial Assistance Program
Extavia Go Program™
1-866-398-2842
www.extavia.com
Glatopa
Glatiramer acetate
Glatopa® [generic equivalent of Copaxone 20mg/ML and 40 mg/ML]
This medication is taken by injection.
Generic Available: Yes
Description
Glatopa® is the generic equivalent of Copaxone (glatiramer acetate). The U.S. Food
and Drug Administration (FDA) has approved Glatopa as substitutable for Copaxone 20mg
(taken daily) and Copaxone 40mg (taken 3 times a week).
Glatiramer acetate is a synthetic protein that simulates myelin basic protein, a
component of the myelin that insulates nerve fibers in the brain and spinal cord. This
drug seems to block myelin-damaging T-cells through a mechanism that is not completely
understood.
Glatopa is approved by the U.S. Food and Drug Administration (FDA) for the treatment
of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome,
relapsing-remitting disease, and active secondary progressive disease, in adults.
Click here to read the FDA Prescribing Information for healthcare professionals.
Click here to read the Patient Information for Glatopa, go to Medication Guide.
Support
GLATOPA SUPPORT PROGRAM
GlatopaCare®
1-855-GLATOPA (1-855-452-8672)
www.glatopa.com/glatopacare/what-is-glatopacare/
Financial Assistance Program
GlatopaCare®
1-855-GLATOPA (1-855-452-8672)
www.glatopa.com
Kesimpta
CD20-directed cytolytic antibody
This medication is taken by injection.
Generic Available: No
Description
Kesimpta® is a monoclonal antibody that binds to a docking site (CD20) on some
immune B cells and depletes them. B cells are among immune cells that have been implicated
in causing nervous system damage in MS. Kesimpta is approved by the FDA for the treatment
of relapsing forms of multiple sclerosis, to include clinically isolated syndrome,
relapsing-remitting disease (RRMS) and active secondary progressive disease, in adults.
Click here to read the prescribing information for healthcare professionals.
Click here to see the medication guide for patients.
Support
KESIMPTA®
1-855-537-4678
www.kesimpta.com/
Financial Assistance Program
Alongside™ KESIMPTA®
1-855-537-4678
www.kesimpta.com/patient-support/financial-resources
Plegridy
Recombinant IFN-β1a
This medication is taken by injection.
Generic Available: No
Description
Pegylated interferon beta-1a is a “pegylated" form of interferon, meaning that
polyethylene glycol is attached to the interferon molecules to allow them to maintain
their biologic effects in the body for longer periods of time. Because the biologic
effects in the body last longer, dosing can occur at less frequent intervals.
This medication is manufactured by a biotechnological process from one of the
naturally-occurring interferons (a type of protein). It is made up of exactly the
same amino acids (major components of proteins) as the interferon beta found in
the human body.
Plegridy is approved by the FDA for the treatment of relapsing forms of multiple
sclerosis, which include clinically isolated syndrome, relapsing-remitting disease
(RRMS) and active secondary progressive disease (SPMS with relapses).
Click here to read the Plegridy prescribing information for healthcare providers.
Click here to read the Plegridy Medication Guide for patients.
Support
Plegridy support services:
Above MS®:
1-800-456-2255
www.plegridy.com/
Financial Assistance Program
GlatopaCare®
1-855-GLATOPA (1-855-452-8672)
www.abovems.com
Rebif
Recombinant IFN-β1b
This medication is taken by injection.
Generic Available: No
Description
Rebif® is a medication manufactured by a biotechnological process from one of the
naturally-occurring interferons (a type of protein). It is made up of exactly the same
amino acids (major components of proteins) as the interferon beta found in the human body.
Rebif is approved for the treatment of relapsing forms of multiple sclerosis, which
include clinically isolated syndrome, relapsing-remitting disease (RRMS) and active
secondary progressive disease (SPMS with relapses).
Click here to read the Rebif prescribing information for healthcare professionals.
Click here to read the Rebif Medication Guide for patients.
Support
REBIF SUPPORT PROGRAM:
MS LifeLines®
1-877-44-REBIF (1-877-447-3243)
www.rebif.com/
Financial Assistance Program
MS LifeLines®
1-877-447-3243
www.mslifelines.com
Oral Medications:
Aubagio
Teriflunomide
This is an oral medication in tablet form.
Generic Available: No
Description
Aubagio® (teriflunomide), a pyrimidine synthesis inhibitor, is an oral compound
that inhibits the function of specific immune cells that have been implicated in MS.
It is related to leflunomide, a drug used to treat rheumatoid arthritis. Aubagio can
inhibit a key enzyme required by white blood cells (lymphocytes) – which in turn
reduces the proliferation of T and B immune cells that are active in MS and also
inhibits the production of immune messenger chemicals by T cells.
Aubagio was approved by the U.S. Food and Drug Administration (FDA) for the
treatment of patients with relapsing forms of multiple sclerosis to include clinically
isolated syndrome, relapsing remitting disease, and active secondary progressive
disease, in adults.
Click here to see the FDA Prescribing Information for healthcare professionals.
Click here to see the FDA Medication Guide for patients.
Support
MS One to One
1-855-MSOne2One (1-855-676-6326)
www.MSOnetoOne.com
Financial Assistance Program
MS One to One
1-855-MSOne2One (1-855-676-6326)
www.MSOnetoOne.com
Bafiertam
Monomethyl Fumarate
This is an oral medication in capsule form.
Generic Available: No
Description
Bafiertam is an oral therapy taken two times per day. Bafiertam is similar to
Tecfidera® and Vumerity® but has a distinct chemical structure. Although their
exact mechanisms of action are not known, fumarate therapies are thought to
modulate the immune response underlying MS to be less inflammatory, and may have
antioxidant properties that could be protective against damage to the brain
and spinal cord.
Bafiertam was approved by the U.S. Food and Drug Administration (FDA) for
the treatment of relapsing forms of multiple sclerosis (MS), to include clinically
isolated syndrome, relapsing-remitting disease, and active secondary progressive
disease, in adults.
Click here to read the Bafiertam Prescribing Information for healthcare professionals.
Click here to read the Medication Guide for patients.
Support
BANNER PATIENT SUPPORT
1-855-322-6637
www.bafiertam.com
Financial Assistance Program
BANNER PATIENT SUPPORT
1-855-322-6637
www.bafiertam.com
Dimethyl Fumarate Delayed-Release Capsules
Dimethyl Fumarate
This is an oral medication in capsule form.
Generic Available: Yes
Description
Dimethyl Fumarate Delayed-Release Capsules is an FDA-approved therapeutic
equivalent to Tecfidera® (dimethyl fumarate). Dimethyl fumarate is a formulation
that was developed specifically for use by people with multiple sclerosis. A
chemically related compound, called Fumaderm (dimethyl fumarate and fumaric acid
esters), has been used at higher doses for decades in Germany to treat acute
flare-ups of psoriasis. Although its exact mechanism of action is not known,
dimethyl fumarate is thought to modulate the immune response to be less inflammatory
and may have antioxidant properties that could be protective against damage to
the brain and spinal cord.
Dimethyl Fumarate Delayed-Release Capsules is approved by the FDA for the
treatment of relapsing forms of multiple sclerosis to include clinically isolated
syndrome, relapsing-remitting disease and active secondary progressive disease in adults.
Click here to read the Dimethyl Fumarate Delayed-Release Capsules Prescribing Information for healthcare professionals (information for patients is at the end of this document).
Support
For more information call:
1-724-514-1800
https://www.viatris.com/en
Financial Assistance Program
No patient assistance program available at this time.
Gilenya
Fingolimod
This is an oral medication in capsule form.
Generic Available: No
Description
Gilenya® is a new class of medication called a sphingosine 1-phosphate receptor
modulator, which is thought to act by retaining certain white blood cells (lymphocytes)
in the lymph nodes, thereby preventing those cells from crossing the blood-brain barrier
into the central nervous system (CNS). Preventing the entry of these cells into the CNS
reduces inflammatory damage to nerve cells.
Gilenya was approved by the U.S. Food and Drug Administration (FDA) for treatment
of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome,
relapsing-remitting disease, and active secondary progressive disease, in patients
10 years of age and older.
Click here to read the Gilenya Prescribing Information for healthcare professionals.
Click here to read the Gilenya Medication Guide for patients.
Support
Gilenya Go Program
1-800-GILENYA (1-800-445-3692)
www.gilenya.com/c/ms-pill/go-program
Financial Assistance Program
Gilenya Go Program
1-800-GILENYA (1-800-445-3692)
www.gilenya.com/c/ms-pill/go-program
Mavenclad
Cladribine
This is an oral medication in tablet form.
Generic Available: No
Description
Mavenclad® is a compound that targets certain types of white blood cells (lymphocytes)
that drive the immune attack in MS. It temporarily reduces the number of both T and
B lymphocytes without continuous suppression of the immune system.
Mavenclad® is approved by the FDA for adults with relapsing forms of multiple
sclerosis, to include relapsing-remitting disease and active secondary progressive
disease. Because of its safety profile, use of Mavenclad is generally recommended
for patients who have had an inadequate response to, or are unable to tolerate, an
alternate drug indicated for the treatment of MS.
Click here to read the Prescribing Information for healthcare providers.
Click here to read the Medication Guide for patients.
Support
MS LifeLines®
1-877-447-3243
www.mslifelines.com
Financial Assistance Program
MS LifeLines®
1-877-447-3243
www.mavenclad.com
Mayzent
Siponimod
This is an oral medication in tablet form.
Generic Available: No
Description
Mayzent® is an immune system-modulating therapy thought to act by retaining
certain white blood cells in the body's lymph nodes, keeping them out of circulation
and out of the central nervous system. Mayzent® also enters the central nervous
system (brain and spinal cord) where it may have direct anti-inflammatory and/or
other effects.
Mayzent® is approved by the FDA for relapsing forms of multiple sclerosis,
which include clinically isolated syndrome, relapsing-remitting disease (RRMS)
and active secondary progressive disease (SPMS with relapses).
Click here to read the prescribing information for healthcare providers.
Click here to read the medication guide for patients.
Support
The Mayzent® Patient Support Program
1-877-629-9368
www.mayzent.com/financial-support
Financial Assistance Program
Alongside MS™
1-877-629-9368
www.mayzent.com/financial-support
Ponvory
Ponesimod
This is an oral medication in tablet form.
Generic Available: No
Description
Ponvory is a selective sphingosine 1-phosphate receptor 1 modulator. It is thought
to act by promoting the retention of certain white blood cells in the body’s lymph
nodes, keeping them out of circulation and from entering the brain and spinal cord.
Ponvory is approved by the FDA for relapsing forms of multiple sclerosis, which
include clinically isolated syndrome, relapsing-remitting disease (RRMS), and active
secondary progressive disease, in adults.
Click here to read the Ponvory Prescribing Information for healthcare professionals.
Click here to read the Ponvory Medication Guide for patients (scroll to page 30).
Support
This medication is expected to be available April 2021. Information on availability,
cost, and patient support programs will be provided when they become available.
Financial Assistance Program
This medication is expected to be available April 2021. Information on availability,
cost, and patient support programs will be provided when they become available.
Tecfidera
Dimethyl Fumarate
This is an oral medication in capsule form.
Generic Available: Yes
Description
Tecfidera® is an oral therapy contained in capsules taken two times per day. Tecfidera,
formerly known as BG-12, is dimethyl fumarate, a formulation that was developed specifically
for use by people with multiple sclerosis. A chemically related compound, called Fumaderm
(dimethyl fumarate and fumaric acid esters), has been used at higher doses for decades in
Germany to treat acute flare-ups of psoriasis. Although its exact mechanism of action is not
known, Tecfidera is thought to modulate the immune response to be less inflammatory and may
have antioxidant properties that could be protective against damage to the brain and spinal cord.
Tecfidera is approved by the FDA for the treatment of relapsing forms of multiple sclerosis
to include clinically isolated syndrome, relapsing-remitting disease and active secondary
progressive disease in adults.
Click here to read the Tecfidera Prescribing Information for healthcare professionals.
Click here to read the Tecfidera Patient Information.
Support
Above MS™
1-800-456-2255
www.AboveMS.com
Financial Assistance Program
Above MS™
1-800-456-2255
www.AboveMS.com
Vumerity
Diroximel Fumarate
This is an oral medication in capsule form.
Generic Available: No
Description
Vumerity® is a capsule taken twice daily by mouth. It is similar to another
disease modifying therapy, Tecfidera, but has a distinct chemical structure
that has been shown to be better tolerated, with fewer reported gastrointestinal
side effects than Tecfidera. Once in the body, Vumerity rapidly converts to the
same active ingredient as Tecfidera. Although its exact mechanism of action is
not known, Vumerity is thought to modulate the immune response to be less
inflammatory and may have antioxidant properties that could be protective
against damage to the brain and spinal cord.
Vumerity is approved by the FDA for the treatment of relapsing forms of
multiple sclerosis to include clinically isolated syndrome, relapsing-remitting
disease and active secondary progressive disease in adults.
Click here to read the Vumerity Prescribing Information for healthcare professionals.
Click here to read the Vumerity Patient Information
Support
Above MS™
1-800-456-2255
www.AboveMS.com
Financial Assistance Program
Above MS™
1-800-456-2255
www.AboveMS.com
Zeposia
Ozanimod
This is an oral medication in capsule form.
Generic Available: No
Description
Zeposia® is a sphingosine 1-phosphate receptor modulator, which is thought to act
by retaining certain white blood cells (lymphocytes) in the lymph nodes, thereby
preventing those cells from crossing the blood-brain barrier into the central nervous
system (CNS). Preventing the entry of these cells into the CNS reduces inflammatory
damage to nerve cells.
Zeposia was approved by the U.S. Food and Drug Administration (FDA) for treatment
of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome,
relapsing-remitting disease, and active secondary progressive disease, in adults.
Click here to read the Zeposia Prescribing Information for healthcare professionals.
Click here to read the Zeposia Medication Guide for patients.
Support
ZEPOSIA 360 SUPPORT™
1-833-937-6742
www.zeposia.com/support-program-for-patients/
Financial Assistance Program
ZEPOSIA 360 SUPPORT™
1-833-937-6742
www.zeposia.com/copay
Infused Medications:
Lemtrada
Alemtuzumab
This medication is given by IV infusion.
Generic Available: No
Description
Lemtrada® is a humanized monoclonal antibody directed at CD52 (a protein on the
surface of immune cells).
Lemtrada is approved by the FDA for the treatment of relapsing forms of multiple
sclerosis, to include relapsing remitting disease and active secondary progressive
disease, in adults. Because of Lemtrada’s safety profile, the FDA recommends that
this medication generally be reserved for people who have had an inadequate
response to two or more MS therapies.
Click here to read the Lemtrada Prescribing Information for healthcare professionals.
Click here to read the Lemtrada Medication Guide for patients.
Support
Call Genzyme at 1-855-MSOne2One (1-855-676-6326)
www.msonetoone.com
Financial Assistance Program
Lemtrada Copay Program
1-855-MSOne2One (1-855-676-6326)
www.lemtrada.com
Novantrone
Mitoxantrone
This medication is given by IV infusion.
Generic Available: Yes
Description
Novantrone belongs to the general group of medicines called antineoplastics.
Prior to its approval for use in MS, it was used only to treat certain forms of
cancer. It acts in MS by suppressing the activity of T cells, B cells, and
macrophages that are thought to lead the attack on the myelin sheath.
The U.S. Food and Drug Administration (FDA) has approved Novantrone for
reducing neurologic disability and/or the frequency of clinical relapses (attacks) in:
1. secondary progressive MS (disease that has changed from relapsing-remitting to
progressive at a variable rate);
2. progressive-relapsing MS (disease characterized by gradual increase in disability
from onset with clear, acute relapses along the way);
3. worsening relapsing-remitting MS (disease characterized by clinical attacks without
complete remission, resulting in a step-wise worsening of disability.
Note: Novantrone has not been approved for the treatment of primary-progressive MS
(characterized by progression from disease onset with no acute attacks or remissions).
Click here to read the Novantrone Prescribing Information for healthcare professionals.
Click here to read the Novantrone Medication Guide for patients.
Support
None available at this time.
Financial Assistance Program
No patient assistance program available at this time.
Ocrevus
Ocrelizumab
This medication is given by IV infusion.
Generic Available: No
Description
Ocrevus® is a humanized monoclonal antibody that targets CD20 positive B lymphocytes
(a type of white blood cell), which contribute to nerve damage in MS.
Ocrevus is approved by the FDA for the treatment relapsing forms of multiple sclerosis
in adults, which include clinically isolated syndrome, relapsing-remitting disease (RRMS)
and active secondary progressive disease (SPMS with relapses). Ocrevus is also approved
by the FDA to treat primary progressive MS in adults.
Click here to read the Prescribing Information for healthcare professionals.
Click here to read the Medication Guide for patients.
Support
Genentech®
1-844-627-3887
Financial Assistance Program
Genentech® Access Solutions
1-877-436-3683
www.Genentech-Access.com
Tysabri
Natalizumab
This medication is given by IV infusion.
Generic Available: No
Description
Tysabri® is a laboratory-produced monoclonal antibody. It is designed to hamper movement
of potentially damaging immune cells from the bloodstream, across the “blood-brain barrier”
into the brain and spinal cord.
Tysabri is approved by the U.S. Food and Drug Administration (FDA) as a monotherapy
(not to be used in combination with other disease-modifying therapies) for the treatment
of relapsing forms of multiple sclerosis, which include clinically isolated syndrome,
relapsing-remitting disease (RRMS) and active secondary progressive disease (SPMS
with relapses).
Click here to read the Tysabri Prescribing Information for healthcare professionals.
Click here to read the Tysabri Medication Guide for patients.
Support
Above MS™
1-800-456-2255
www.AboveMS.com
Financial Assistance Program
Above MS™
1-800-456-2255
www.AboveMS.com
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