With High Costs and Similar Benefits, Use of New Neurologic Drugs Is Low

A study published in Neurology showed that a number of new neurologic medications for diseases such as multiple sclerosis (MS), Parkinson disease (PD), and migraine have received Food and Drug Administration (FDA) approval, but only a small percentage of patients are being treated with them due to high out-of-pocket costs and benefits that are similar to less expensive drugs.

For the study, researchers used a private insurance claims database to identify people with 11 neurologic conditions and a prescription for a new or existing drug. The researchers calculated the proportion of people receiving new medications versus all medications for each condition and found that fewer than 20% of participants were taking new medications for all conditions except tardive dyskinesia.   

“For new, high-cost medications that have similar effectiveness to older drugs, limited use is likely appropriate,” said Brian C. Callaghan, MD, MS, University of Michigan Health. “However, future studies are needed to look into whether the high costs are barriers to those new medications that can really make a difference for people living with neurologic disease.” 

The study included people with migraine, MS, PD, orthostatic hypertension, myasthenia gravis, tardive dyskinesia, amyotrophic lateral sclerosis (ALS), Huntington disease (HD), transthyretin amyloidosis, Duchenne disease, and spinal muscular atrophy (SMA). 

New medications were defined as those that received FDA approval between 2014 and 2018. Overall, out-of-pocket costs and total costs for the new drugs were substantially larger than for the existing drugs. Out-of-pocket costs for new drugs were also highly variable and unpredictable compared to the costs for existing medications.