Supplements | Improving Clinical and Economic Outcomes in Multiple Sclerosis [CME/CPE]

CME Information

Release date: January 15, 2013 |  Expiration date: January 15, 2014
Estimated time to complete activity:  3.0 hours
Type of Activity: Knowledge  |  Medium: Print with Internet-based posttest, evaluation, and request for credit

This activity is supported by an educational grant from EMD Serono, Inc, and Teva Pharmaceuticals, Ltd.

Intended Audience
Medical directors, pharmacy directors, specialty pharmacists, and other managed care professionals who oversee the care of patients with multiple sclerosis.

Statement of Educational Need
A chronic, progressive autoimmune disorder of the central nervous system, multiple sclerosis (MS) is estimated to affect approximately 400,000 Americans, and it appears to be increasing in incidence, especially among women. Both the symptoms and course of MS appear to be somewhat unpredictable, with some individuals experiencing mild illness, with few relapses that produce effects such as fatigue, numbness, and stiffness. Other patients suffer from more progressive disease and experience increasingly severe symptoms (eg, slurred speech, tremors, difficulty walking, cognitive dysfunction) and permanent disability.
 
Because MS is chronic and disabling—and because, despite their disability, most people with MS have a normal life span—MS imposes considerable cost on individuals, families, the healthcare system, and society. Since MS patients are typically affected in the prime of their life, most of the total costs are related to indirect costs such as lost productivity and income, assistive equipment, disability-related home modifications, and paid or unpaid personal care. Treatment with disease-modifying drugs (DMDs) has increasingly been shown (in relapsing disease) to have positive long-term outcomes, including a reduction in the frequency of relapses, reduction in brain lesion development, and possible reduction of disability progression. As a result, clinicians and researchers have concluded that these agents are likely to reduce future disease activity and improve patient quality of life. However, treatment must be sustained for years, as discontinuation may result in pre-treatment disease activity.
 
As with most chronic conditions, MS presents several clinical as well as managed care challenges that are inherent to managing patients requiring lifelong treatment and follow-up. With studies indicating that a considerable percentage of patients are not being treated with a DMD, the main issues in this disease are making treatment available to all patients and assuring that patients maintain treatment. This activity is intended to examine the epidemiology, pathophysiology, and clinical progression of MS. The discussion will include a significant focus on current therapeutic strategies for slowing disease progression, common adverse events associated with MS therapies, and strategies for mitigating these side effects. Also included is an examination of managed care–related issues surrounding MS and disease management  opportunities to improve economic and clinical outcomes in MS.

Educational Objectives
Upon completion of the educational activity, the participant should be able to:
  • Describe the clinical and economic burden associated with HCV infection
  • Evaluate current and emerging therapeutic strategies for slowing disease progression in patients with MS and their role in the treatment paradigm
  • Describe common adverse events associated with MS therapies and strategies for mitigating these side effects
  • Identify improved risk assessment and risk management strategies in the management of MS in managed care
  • Examine disease management opportunities, including medication adherence to improve economic and clinical outcomes in MS

Activity Fee
Physician: This activity is free of charge for physician participants requesting AMA PRA Category 1 CreditTM.
Pharmacist: The activity is free for participants submitting evaluation forms and posttests online for pharmacy credit. For participants submitting their posttests/evaluation forms and requests for credit via fax or mail, there is a nominal fee of $10.00.

Disclosure Policy
According to the disclosure policies of Physicians’ Education Resource, LLC, and Pharmacy Times Office of Continuing Professional Education, all persons who are in a position to control content are required to disclose any relevant financial relationships with commercial interests. If a conflict is identified, it is the responsibility of Physicians’ Education Resource and Pharmacy Times Office of Continuing Professional Education to initiate a mechanism to resolve the conflict(s). The existence of these relationships is not viewed as implying bias or decreasing the value of the activity. All educational materials are reviewed for fair balance, scientific objectivity of studies reported, and levels of evidence.

Physician Credit
Accreditation Statement / Credit Designation
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Physicians’ Education Resource and Pharmacy Times Office of Continuing Professional Education. Physicians’ Education Resource is accredited by the ACCME to provide continuing medical education for physicians.

Physicians’ Education Resource designates this journal-based CME activity for a maximum of 3.0 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Pharmacist Credit
Accreditation and Credit Designation
Pharmacy Times Office of Continuing Professional Education is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 3.0 contact hours (0.3 CEUs) under the ACPE universal activity number 0290-9999-13-109-H01-P. The activity is available for CE credit through January 15, 2014.

Obtaining Credit
Participants must read each article in this supplement, complete the posttest (achieving a passing score of 70% or higher), and complete an evaluation and request for credit. Detailed instructions on obtaining CE credit are included on the evaluation/posttest page contained in this supplement.

Faculty
A. Scott Mathis, PharmD
Administrative Director
Pharmacy and Medication Use
Pharmacy Department
Monmouth Medical Center
Long Branch, New Jersey

Mark J. Tullman, MD
Director of Clinical Research
MS Center for Innovations in Care
Missouri Baptist Medical Center
St. Louis, Missouri


Faculty Disclosures
These faculty have disclosed the following relevant commercial financial relationships or affiliations in the past 12 months.

A. Scott Mathis, PharmD has no relevant financial relationships with commercial interests to disclose.

Mark J. Tullman, MD, has disclosed the following relevant commercial financial relationship:
Consultant/advisory board: Acorda Therapeutics, Allergan, Biogen Idec, Genzyme, Novartis, and Teva Pharmaceuticals
Grants: Acorda Therapeutics
Honoraria: Acorda Therapeutics, Biogen Idec, EMD Serono, Novartis, Pfizer, and Teva Pharmaceuticals

The American Journal of Managed Care 
Publishing Staff—Jeff D. Prescott, PharmD, RPh; Kara Guarini, MS; and Ida Delmendo have no relevant financial relationships with commercial interests to disclose.

Pharmacy Times Office of Continuing Professional Education and Physicians’ Education Resource, LLC 
Planning Staff—Judy V. Lum, MPA; Elena Beyzarov, PharmD; and Donna Fausak have no relevant financial relationships with commercial interests to disclose.
Signed disclosures are on file at the office of The American Journal of Managed Care, Plainsboro, New Jersey.

University of Cincinnati
Planning Staff—Susan P. Tyler, MEd, CMP, CCMEP, has no relevant financial relationships with commercial interests to disclose.
Physician Reviewer—Rick Ricer, MD, has no relevant financial relationships with commercial interests to disclose.
 

Opinions expressed by authors, contributors, and advertisers are their own and not necessarily those of Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, the editorial staff, or any member of the editorial advisory board. Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, is not responsible for accuracy of dosages given in articles printed herein. The appearance of advertisements in this publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality, or safety. Clinical Care Targeted Communications, LLC, d/b/a Managed Care & Healthcare Communications, LLC, disclaims responsibility for any injury to persons or property resulting from any ideas or products referred to in the articles or advertisements.

Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

System Requirements
PC-based participants
Windows 7, Vista, XP, 2003 Server, or 2000

Macintosh®-based participants
Required: Mac OS X 10.4.11 (Tiger) or newer

© 2013 Managed Care & Healthcare Communications, LLC

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