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A new medication for multiple sclerosis called Tecfidera (dimethyl fumarate) promises to reduce relapses and extend remissions, for just US $54,900 per year.

Tecfidera does not pose some of the unacceptable risks presented by earlier MS drugs--such as death. But that doesn't mean that Tecfidera is free of side effects.

Fewer than 1% of participants in the study died during the trial, fewer than 2% of participants in the study were diagnosed with cancer during the trial, but among the participants taking two doses of the drug daily:

  • 2% experienced a serious infection.
  • 4% experienced leukopenia, a potentially dangerous decline in white blood cell count. (The average decline in white blood cell count in the twice-a-day group, which was not considered to be "serious," was 28%.)
  • 10% experienced vomiting.
  • 10% experienced itching.
  • 11% experienced abdominal pain.
  • 13% experienced nausea.
  • 38% experienced facial flushing, and most significantly,
  • 27% experienced a relapse of the underlying disease.

Two Pills a Day Cause More Side Effects than Three

For the most part, participants in the trial who took three doses of the medication per day had fewer side effects, but also fewer benefits. And since MS often causes most of the symptoms listed here, except facial flushing, only leukopenia (lowered white blood cell counts) and relapses of the disease itself were considered "serious."

Inteferon-beta and glatiramer acetate, which often cause flu-like side effects (glatiramer acetate can also cause lumps to form at the injection site, as well as facial flushing and rapid heartbeat), are effective in only about 30% of cases. Drugs like Tysabri are effective in 60 to 70% of cases, but can cause death. Tecfidera seems to work about 50% of the time, with relatively few serious side effects. Among the drugs for MS that on the market now, it is is clearly one of the best--but at $80 a pill for a medication that has to be taken twice a day, how could anyone pay for it?

Paying for Tecfidera After Obamacare

When the Affordable Care Act kicks in on January 1, 2014, every American health insurance plan will have to cover MS even if it is a pre-existing condition, and out-of-pocket drug costs, for most consumers, will be drastically reduced.

It's important to realize, however, that open enrollment for the new health insurance plans begins October 1, 2013, and it is necessary to be enrolled before January 1, 2014 to get full benefits.

Families that earn less $46,000 per year will be able to apply for Medicaid coverage of their insurance premiums. These plans will cover essentially the entire cost of medications such as Tecfidera.

Families that earn up to $90,000 per year will be able to get health insurance at reduced rates. They can buy health insurance that covers almost the entire cost of medications such as Tecfidera.

The Biogen Idec Access Program

And in the meantime, the Biogen Idec Access Program will help with the costs of the medication for people who do not otherwise have the resources to pay for it. If you have a diagnosis of MS, a prescription for Tecfidera, you are a citizen or legal resident of the United States and its territories, you do not have health insurance, you are not eligible for Medicare Part D, and you meet an undisclosed income guideline (you will have to ask the company for details), then you may be able to get the drug at a cost of $25 for a 90-day supply (a discount of over $14,000 every three months). Call 1-800-456-2255 for more information. And don't forget to send a thank-you note when you get the drugs.

  • Gold R, Kappos L, Arnold DL, Bar-Or A, Giovannoni G, Selmaj K, Tornatore C, Sweetser MT, Yang M, Sheikh SI, Dawson KT
  • DEFINE Study Investigators. Placebo-controlled phase 3 study of oral BG-12 for relapsing multiple sclerosis. N Engl J Med. 2012 Sep 20. 367(12):1098-107. Erratum in: N Engl J Med. 2012 Dec 13
  • 367(24):2362. PMID: 22992073.
  • Ropper AH. The "poison chair" treatment for multiple sclerosis. N Engl J Med. 2012 Sep 20. 367(12):1149-50.
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