About 1 million people in the United States have multiple sclerosis (MS), a disorder where the immune system attacks myelin, a layer that protects neurons in the central nervous system, leading to symptoms such fatigue, numbness or tingling throughout the body, difficulty with balance and coordination, vision impairment and muscle weakness, with some eventually losing the ability to walk independently. 

While there’s no cure for MS, treatments can help modify the course of the condition and manage symptoms. For example, disease-modifying therapies (DMTs) help reduce the frequency and severity of symptoms and minimize lesions in the brain and spinal cord.  

However, MS is expensive to treat. A study commissioned by the National MS Society found that people with MS spend an average of $65,612 more on medical care annually compared to those who do not have MS. Therapies for this condition rank as the sixth most expensive drug category as a result of high-cost drugs like DMTs, based on Prime’s commercial medical and pharmacy claims data. 

That’s where Prime’s HighTouchRx^® product can help. 

Using exclusive clinical predictive modeling applied to integrated medical and pharmacy data, this product quickly identifies members using high-cost therapies and recommends more cost-effective medications. For example, HighTouchRx — which targets all drug therapies that cost $1,000 or more with generic equivalents — can identify patients taking brand-name drugs and recommend switching to cheaper but similarly effective alternatives. This tool has saved clients more than $15.5 million in MS drug savings, according to internal Prime data. 

“Based on our research, we know patients with MS are more likely to stick to their treatment when the cost of medications is low,” said Nick Friedlander, who presented the research study “Promoting Generic Multiple Sclerosis Drug Utilization and Drug Cost Savings with a Managed Care Pharmacist Outreach Program” at the Academy of Managed Care Pharmacy (AMCP) Nexus 2024. “Having a clear idea of the total cost for medications to treat MS helps us guide providers to using the best course of treatment while sparing our clients needless expense in an already costly category.” 

Personalized support leads to better health outcomes 
While affordability is a key consideration when treating MS, it’s equally important that patients are on a medication that most effectively manages their condition. GuidedHealth^® helps patients and their prescribers make better decisions about medicines through a centralized system that helps guide medication choices and identify opportunities for better management of pharmacy utilization, gaps in care, safety and costs. This contributes to improved patient outcomes and overall health care costs.  

“It’s not just about managing medications; it’s about guiding better health decisions every step of the way,” said Sara Manderfield, director of clinical program capabilities. “GuidedHealth empowers members in their health care journeys by identifying potential gaps in care, medication safety concerns and opportunities for cost savings. This helps to make sure medications are used appropriately and effectively.”  

Prime internal data shows that 4 in 10 of Prime’s members were not adherent to their MS drug therapy in the last 12 months. This may be because of high out-of-pocket costs, side effects, complex regimens, lack of access to transportation and other factors. Prime’s Care Specialists Program helps address those barriers to care, with personalized support from pharmacists and nurses specifically trained in MS who work one-on-one with patients to help with side effects, dosage schedules and to answer any questions about the condition. It also offers digital resources to support treatment, including text message refill reminders, live video calls and an online Education Center. Ninety-eight percent of patients got the answers they needed about their meds through the Care Specialists Program, according to 2023 Prime internal data based on survey responses from patients enrolled in the Care Specialists program. 

Support for MS through charity partner  

Prime’s passion for helping people goes beyond health care, with employees’ ongoing support of four charity partners, including the National MS Society, through the Prime Together Foundation. In addition to raising more than $30,032 for the Society, Prime employees also participate in local events and volunteer to support the mission of finding a cure for MS and addressing the challenges that those with MS face.  

Marissa Grams, a senior provider relations analyst at Prime who was diagnosed with MS in 2021, shared her diagnosis and MS journey in a recent article that highlighted MS Awareness Week.  

“Raising awareness about MS is crucial for finding a cure and supporting those affected,” Grams said. “My hope is that soon, no other family will be impacted by this disease.” Her story exemplifies why Prime remains committed to improving care access and driving awareness for MS patients nationwide. Earlier this month, she walked in the annual MS Society Walk in Minneapolis, Minnesota, which she has participated in for the last 10 years.

May 30 is World Multiple Sclerosis Day 

Prime Therapeutics is proud to support the MS community in recognizing World MS Day on May 30. Every year, this day is dedicated to raising awareness about MS. This year’s theme, "My MS Diagnosis," promotes early and accurate diagnoses for everyone living with MS and highlights challenges and barriers to diagnosis. This World MS Day, join Prime in raising awareness, advancing research, advocating for better treatment and delivering hope. Learn more at NationalMSSociety.org/MS-Awareness-Day. 

Learn more about how Prime helps clients and members manage multiple sclerosis 

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