Ocrevus and PPMS: Where to from here?

The following is an opinion piece written by MStranslate co-founder, Brett Drummond.

Let’s rewind to last March last year…there is worldwide excitement as ocrelizumab (Ocrevus) becomes the first treatment to obtain FDA approval for the treatment of primary progressive multiple sclerosis (PPMS).  After having gone such a long time without any available options, was this a new ray of hope for people living with PPMS?

Looking past the media hype at the time, it was clear from the published trial results that the benefits of Ocrevus in this group were small.  To put it simply, the effectiveness of the treatment was moderate at best and, if similar results had been seen as a relapsing-remitting MS (RRMS) therapy, it probably wouldn’t have gained anywhere near as much attention.

Regardless, since approval was given, the problem has been getting Ocrevus included on support schemes that would make it both more accessible and affordable (such as the Pharmaceutical Benefits Scheme in Australia).  Why is this the case?

Most of these organisations take into account a cost-benefit analysis of every treatment.  As it stands, the benefits seen for people living with PPMS are too small compared to the cost that is being quoted by Roche (the pharmaceutical company that developed Ocrevus).  

A recent article, available here, says that Roche would be interested in offering a discounted price for people living with PPMS, compared to the cost currently charged to people using Ocrevus for RRMS.  However, European authorities aren’t allowed to consider a proposal such as this.

So where does this leave people living with PPMS?  My guess is that there is probably a feeling of overwhelming frustration.  Finally, a treatment becomes available that may provide some assistance (even if minor), yet their access is incredibly limited due to this regulation battle.  

How do we fix these types of scenarios?  I honestly don’t know….economics and regulatory bodies aren’t my strong suit!  Having said that, it is clear that compromise is required.  It is a complicated issue and just placing the blame on the pharmaceutical companies, while a common response, isn’t going to help.  

In my opinion, it is critical that during these discussions everyone remembers that these decisions are having real impacts on real people around the world.

What are your thoughts on this issue?  I’d love to engage in a discussion on this topic and see what ideas can be generated.  You can comment below this article, on our Facebook page under the linked post or tweet us at @MStranslate.