Focus on Multiple Sclerosis: Benefits of Advanced Pharmacist Certification, a Glimpse into the Drug Pipeline

Given the significant advancements in multiple sclerosis (MS) treatments and new therapies in the pipeline, pharmacists who work with individuals affected by MS will, ideally, be equipped with specialized knowledge of how to manage their complex needs and better service this patient population.

MS-Certified Specialist (MSCS) is the certification offered by the Consortium of Multiple Sclerosis Centers. The knowledge and expertise gained during the process of earning certification helps to improve the quality of care within the MS patient population.

Clinically, having a deeper understanding of the condition helps to build rapport with patients, provide more meaningful care, and optimize outcomes. From a career perspective, certification aligns with a commitment to excellence and growth as a health care provider. In 2021 alone, clinical pharmacists at Shields Health Solutions (ShieldsRx) earned new or renewed certifications in HIV, organ transplant, and other areas, as well as MS.

The MSCS designation recognizes an advanced level of competency and specialization to provide the best and most consistent care to individuals and families living with MS. The process includes learning about the different modalities involved in MS care to better identify patient needs—not only in terms of medication, but in terms of social determinants of health (SDOH) as well, such as social challenges (financial, transportation, or housing); psychological challenges and emotional wellbeing; cognitive changes and decline in physical function.

The certification enables improved collaboration with the MS team to enhance patient care outcomes and promote overall patient experience.

From optimizing medication therapy management to recommending interventions to help with symptomatic management, a pharmacist specializing in MS can:

• Extend a high level of empathy and compassion to patients and caregivers as they navigate through challenges on their journey with MS.
• Recognize patient concerns and provide reassurance—guiding patients and caregivers to available resources, such as support groups, to help relieve stress and burden.
• Serve as a dependable, trusted resource for patients and caregivers seeking information, addressing their concerns and uncertainties.

MS is a chronic, immune-mediated disease with no cure at present. Therefore, the focus of therapy is aimed toward slowing disease progression and reducing flares because a higher number of MS relapses, particularly within the first 2-5 years of the disease, is linked to increased disability accumulation and decreased quality of life.

Pharmacists are positioned on the front lines of providing patient education, connecting with patients and caregivers, and helping them develop and implement strategies to improve adherence, manage symptoms, prevent relapses, reduce hospitalizations, and health care costs. Educating patients and expanding their understanding and knowledge of the condition empowers them to take part in a more active role in managing their health. 

Caring for patients with MS is a rewarding experience for the ShieldsRx team. Patients value and often express appreciation for the team’s ongoing support and dedication to improving their care and quality of life, given the many physical, psychological, and social challenges the disease can cause.

Several exciting new drugs with the potential to change the MS treatment landscape are in the pipeline. Expected soon is ublituximab, a glycoengineered anti-CD20 monoclonal antibody intended to treat relapsing forms of MS, developed by TG Therapeutics with an anticipated PDUFA date September 28, 2022.

Further down the road are several drugs in a class of medications called Bruton’s Tyrosine Kinase (BTK) inhibitors. BTK inhibitors have the potential to remove unwanted autoreactive B cells without removing all B cells, whereas current anti-CD20 drugs wipe out all B cells.

There are currently 3 BTK inhibitors in phase 3 trials that could come to market in the next couple of years: tolebrutinib from Sanofi, evobrutinib from Merck, and fenebrutinib from Genentech. It is possible that these medications could treat both relapsing and progressive forms of MS, modifying the course of the disease by limiting new areas of damage in the central nervous systems, reducing the number of relapses, and delaying progression of disability.

The ShieldsRx trade relations team works with drug manufacturers to gain access to specialty medications such as these for our health system partners. Conversations with manufacturers highlight the value provided by the ShieldsRx care model and the ability to start patients on therapy quickly and maintain them on therapy to optimize outcomes.

The ShieldsRx trade relations team identifies pipeline drugs—sometimes several years before approval—and engages manufacturers early on in their process of determining distribution channels. As the premier specialty pharmacy accelerator in the United States, ShieldsRx partners with more than 70 health systems.

ShieldsRx enhances product launches and helps to convert clinical trials at health system partner sites. After access is established and the drug is approved, ShieldsRx works closely with trial coordinators to seamlessly transition patients and prescriptions once trial participation has ended.

Currently, ShieldsRx works with more than 100 MS clinics in the United States and secured more than $11 million in financial assistance in 2020 on behalf of 5000 patients with MS who have access to the Shields Care Model.

About the Authors

Tina Cheng, PharmD, MCSC, is a clinical pharmacist at Shields Health Solutions.

Ben May, PharmD, CSP, is director of specialty drug trend and pipeline at Shields Health Solutions.

References

• “Understanding MS.” National Multiple Sclerosis Society, https://www.nationalmssociety.org/What-is-MS/MS-FAQ-s (Accessed March 25, 2022)
• Kalincik T. Multiple Sclerosis Relapses: Epidemiology, Outcomes and Management. A Systematic Review. Neuroepidemiology. 2015;44(4):199-214.
• Hoffman, Matt. “Pipeline Update: Status of Clinical Development for Multiple Sclerosis”. Neurology Live. July 20, 2021. https://www.neurologylive.com/view/pipeline-update-status-clinical-development-multiple-sclerosis Accessed on March 17, 2022.
• Dolgin, Elie. “BTK blockers make headway in multiple sclerosis”. Nature Biotechnology. January 11, 2021. https://www.nature.com/articles/s41587-020-00790-7 Accessed on March 17, 2022.