2021 CMSC Annual Meeting

Improving Communication Gaps between Physicians Who Treat MS and the Health Insurance Community


Background: Bridging gaps in communication between managed care decision makers and multiple sclerosis (MS) clinical specialists can contribute to long-term improvements in the overall quality of care delivered to patients living with MS. Objectives: Presentations focused on current MS therapies and treatment strategies, the impact of drug cost on access and delivery of care, and the importance of multidisciplinary management of individuals with MS. Discussions among the participants yielded recommendations on improving efficacy on delivery of care; enhancing multidisciplinary management; reducing barriers between physicians, payers, and specialty pharmacy providers; and improving continuity of care Methods: To foster this collaboration, between August of 2019 and January of 2020 MSAA and Impact Education convened four in-person roundtable meetings. Each event featured differing panels of payers, physicians, and specialty pharmacy providers in differing parts of the country, with the potential of influencing over 88,100 patients within each attendees’ network. Results: Incorporating these recommendations has the potential to advance patient outcomes, expand access to appropriate therapy, and increase the overall value of MS care. As such, to disseminate the information to the broadest network of individuals, MSAA and Impact Education co-developed a white paper based on the findings titled, “The Evolving Landscape in the Management and Treatment of Multiple Sclerosis”. Detailing not only the current treatment paradigm as it impacts patients, physicians, and payers, the whitepaper also relays practical recommendations that can help bridge the communication gap. Conclusions: Looking forward, roundtable participants leaned heavily into the formation of steering committees for ongoing conversations to (1) maximize evidence-based treatment guidelines, (2) ensure health plan structures give patients access to the most recent therapeutic drug advances; (3) mitigate disruptions caused by changes in formulary status of drugs; and (4) share clinical, safety, and adherence data on a regular basis and establish a plan for dissemination. 100% of provider participants plan to begin or continue care management approaches including shared decision making 86% of payer attendees intend to begin or continue exploring medical or pharmacy strategies to enhance MS patient outcomes, and 100% intend to advocate for healthcare policies that advance health care value, patient well-being, and expand access to appropriate care for MS.