Evaluating the Future of MS Therapies: Balancing Early Data With Delayed Outcomes

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

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

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

EP: 8.Short-Term Wins vs Long-Term Gains: Rethinking MS Treatment Value

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EP: 9.Evaluating the Future of MS Therapies: Balancing Early Data With Delayed Outcomes

Video content above is prompted by the following:

The integration of wearable technology represents a promising frontier for multiple sclerosis (MS) disability monitoring, offering continuous assessment of mobility, balance, and activity levels beyond traditional clinic visits. Current limitations include data ownership issues, platform inconsistencies, and the challenge of standardizing metrics across different devices and manufacturers. While technologies like Apple Watch can track steps and movement patterns, the lack of standardized, consistent platforms that maintain data integrity over time presents significant barriers to clinical adoption and payer acceptance.

Emerging imaging technologies are revealing new insights into MS pathology, particularly slowly expanding lesions (SELs) and iron deposits characteristic of smoldering MS. These advanced MRI techniques can identify disability progression independent of relapse activity, providing objective evidence of the neurodegenerative processes that Bruton tyrosine kinase (BTK) inhibitors aim to address. However, these sophisticated imaging capabilities remain primarily confined to academic medical centers, limiting their widespread clinical utility and payer evaluation criteria.

The “cover and collect” approach for BTK inhibitors reflects the urgency of treating progressive MS where therapeutic options have been historically limited. Rather than waiting for extensive postmarket data, payers should consider covering these agents while simultaneously collecting real-world evidence of their effectiveness. This approach acknowledges that time is critical in MS progression, and delaying access to potentially effective treatments could result in irreversible disability accumulation that ultimately increases long-term health care costs.