Between 1993 and 2015, the US Food and Drug Administration (FDA) approved 13 drugs for the treatment of relapsing-remitting multiple sclerosis (MS). While these disease-modifying therapies (DMTs) fall into 7 different categories and vary in route of administration, adverse effects, and efficacy, they have one commonality—they are all very expensive, with acquisition costs exceeding $60 000 a year and continuing to escalate.1 One potential reason for the skyrocketing costs of MS DMTs is that they have never faced price competition from lower-cost generic drugs. The recent FDA approval of a generic version of branded glatiramer acetate (Copaxone; Teva Pharmaceuticals) signals the promise of true price competition among MS DMTs. However, the economic effect of the availability of a generic DMT is as yet unclear because this depends on the price of the generic and the extent of its use. Although pricing decisions are beyond our control, neurologists can have a large influence on how generic DMTs are used. As such, neurologists need to assess whether or not generic glatiramer acetate is equivalent to branded glatiramer acetate and acceptable for use in treating MS.
Dennis Bourdette, Daniel Hartung. Equivalence of Glatiramer Acetate Generics With Branded Glatiramer Acetate in Efficacy and Cost for the Treatment of Multiple Sclerosis. JAMA Neurol. 2015;72(12):1411–1413. doi:10.1001/jamaneurol.2015.2605