In a video interview with Practical Neurology® at the AAN Meeting, Dennis Bourdette, MD, Chair of the Department of Neurology and Director of the Multiple Sclerosis and Neuroimmunology Center at Oregon Health & Science University, discussed the growing problem of rising drug prices and their impact on physicians’ ability to treat patients. “Because of this tremendous increase in price, insurance companies have instituted a variety of measures to limit access, particularly through step therapy, where they have two or three preferred drugs that you have to start first without special permission, which is very arduous to get,” he explains.

Dr. Bourdette believes that neurologists owe it to patients and to their profession to speak out on the issue. “It’s just as much of an obligation to our patients as the care we provide them in the office,” he observes. “If we have a healthcare system that has prices for clearly important drugs becoming outrageously high, it’s going to have a negative impact on the entire healthcare system and directly impacts our ability to use these miraculous drugs for the care of our patients.”

Concerns Over PML Case in Ocrevus Downplayed Due to Patient’s Three-Year History on Tysabri

The first case of progressive multifocal leukoencephalopathy in a patient receiving Ocrevus (ocrelizumab, Genentech/Roche) was reported last month. Concerns have been eased, however, by the fact that the patient was previously receiving Tysabri (natalizumab, Biogen), which has been known to increase risk of the brain infection. The patient who developed PML had previously tested positive for John Cunningham virus, a common virus that can lead to PML. “Patient safety is Roche’s highest priority and we are gathering more details about the case and the patient’s history,” Roche said in a statement. The company has assured clinicians that it will continue to share information after investigating the case.


New Developments in Concussion

Francis Conidi, DO reviews the latest data on post-concussion headache, while Tad Seifert, MD sheds light on the future of research and therapeutics. Additionally, Kristine O’Phelan, MD reflects on the challenges and perceptions of concussion management. Watch out for these stories and more in the next edition of Practical Neurology®.

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By Stewart J. Tepper, MD