Bridging the Gaps: BTK Inhibitors and the Future of MS Care

EP: 1.Understanding PIRA and Its Clinical Significance in MS

EP: 2.Measuring What Matters: Evidence and End Points That Define Disability in MS

EP: 3.Closing the Gaps: Therapeutic Performance and the Promise of Innovation

EP: 4.Digging Deeper: Mechanisms of Progression and the Case for a Dual Therapeutic Approach

EP: 5.Aligning Evidence With Access: Disability Outcomes, Data, and Payer Decision-Making

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EP: 6.Bridging the Gaps: BTK Inhibitors and the Future of MS Care

EP: 7.Redefining Value: What Payers Want From Comprehensive MS Treatments

Video content above is prompted by the following:

The multiple sclerosis (MS) treatment landscape has dramatically evolved from just 4 interferon-based agents in 2010 to over 22 disease-modifying therapies by 2025. This explosion of treatment options has created both opportunities and challenges for payers, as MS drugs consistently rank among the top-utilized medications despite affecting less than 1% of the US population. The key gap in current MS management lies in traditional step therapy protocols that force patients to fail older, less effective treatments before accessing newer therapies that target underlying disease pathology.

Bruton tyrosine kinase (BTK) inhibitors represent a breakthrough class of oral therapies currently in phase III trials, with potential FDA approval by late 2025. These small molecules uniquely cross the blood-brain barrier and address both inflammatory and neurodegenerative components of MS. Unlike existing therapies that primarily target relapsing forms of MS, BTK inhibitors show promise for progressive MS forms, including secondary progressive and primary progressive disease, where treatment options have been historically limited.

The discussion emphasizes the critical importance of treating MS patients “early, soon, and aggressively” to prevent long-term disability progression. Evidence demonstrates that prompt treatment with newer therapies can slow disease progression by up to 50%. The challenge for payers lies in balancing formulary management with the urgent need to provide timely access to effective treatments for this predominantly working-age population, where delays in appropriate therapy can significantly impact quality of life and productivity.