Rituximab for Multiple Sclerosis: Hiding in Plain Sight

Area of Science:

• Neurology
• Pharmacoeconomics
• Public Health Policy

Background:

• Relapsing multiple sclerosis (RMS) treatment landscape is dominated by high-cost disease-modifying therapies.
• Rituximab, an effective treatment option, faces barriers to access and coverage.
• Recent policy recommendations and global health listings highlight the need for improved rituximab utilization.

Purpose of the Study:

• To analyze the current status of rituximab utilization for RMS.
• To evaluate the impact of recent policy recommendations on rituximab access.
• To advocate for increased use of rituximab and its biosimilars for RMS.

Main Methods:

• Review of Institute for Clinical and Economic Review (ICER) policy recommendations from February 2023.
• Analysis of World Health Organization (WHO) essential medicine listing for rituximab in July 2023.
• Assessment of persistent barriers to rituximab coverage and utilization.

Main Results:

• ICER recommended removing barriers to rituximab coverage and endorsing its use for RMS.
• WHO listed rituximab as an essential medicine for multiple sclerosis.
• Despite these endorsements, significant barriers to rituximab access and utilization persist.

Conclusions:

• Rituximab remains underutilized for RMS despite its efficacy and essential medicine status.
• Stakeholders, including payers, professional societies, and clinicians, must actively promote rituximab coverage and use.
• Addressing health inequities requires improving access to affordable and effective treatments like rituximab for RMS.