In 2018, the MS world received its first true generic DMT, and more generics will become available over the next few years. Studies in other disease states have shown a nocebo effect due to a mistrust of generic medications, leading to worse clinical outcomes and higher medical costs when patients are mandated to switch from a branded maintenance medication to a generic. To learn if there could be a risk of a nocebo effect for patients with MS, this study focused on understanding patients views towards generic DMTs.
Primary: Measure the views of patients with MS toward generic DMTs.
Secondary: Observe opportunities for pharmacists to impact patient DMT trust through counseling.
This was a multi-site study where patients with MS were surveyed during their monthly refill calls. The surveys were administered verbally by the health system specialty pharmacy pharmacists and liaisons. The results were compiled in a survey system and analyzed.
A total of 62 patients opted in to complete the survey. The average years with MS was 11, and 87% were diagnosed with RRMS. 42% were being treated with a generic, and 51% had been exposed to a generic DMT during their treatment history. 68% of the overall population trusted generic DMTs, with 6% not trusting, and 26% not having an opinion.
Comparing those currently being treated with generic DMTs (arm 1) to those on branded DMTs (arm 2), more in arm 1 (73% vs. 64%) trusted generic DMTs, more in arm 2 (0% vs. 11%) did not trust generic DMTs, and more in arm 1 (27% vs. 25%) had no opinion. The top 3 reasons to choose a DMT for the generic DMT population were affordability, efficacy, and side effects, while the top 3 reasons for the branded DMTs population were efficacy, affordability and administration route (tied), and side effects.
While the majority of patients with MS surveyed trusted generic DMTs, there was still a large portion (32%) who did not trust or did not have a current opinion on generic DMTs. All of the patients who did not trust generic DMTs were being treated with branded DMTs, and this population valued efficacy more than affordability. More research is needed to confirm these results; however, this study shows that there is a population of patients with MS who could be susceptible to a nocebo effect should they be mandated to switch to a generic medication. Pharmacists could help prevent this by learning the patients values for choosing a DMT and counseling confidence in the treatment they have been prescribed.