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Tom Schrette and Alan Cash

Tom Schrette and Alan Cash

Dear Tom and Alan:

A while ago, you did a column on a medication for multiple sclerosis. It was not a cure, it just helped somehow. Anyway, it was ungodly expensive.

What was it, again? Is it still out of reach for most people?

Now I’m Interested

Tom: The medication is called Ocrevus and it is still ungodly expensive. Checking both medicare.gov and the United Health Care website, I find that Ocrevus is not on anybody’s formulary. On the AARP Medicare Rx Preferred plan, the monthly cost is $19,501.

The other medication is Rituxan. It is a tier 5 drug and costs about $319 per month.

Al: By the way, the $19,501 is simply the retail cost of the drug. The tier 5 classification for Rituxan means that it is on the formulary and is considered a “specialty” drug. Tiers 1 and 2 are generic, tiers 3 and 4 are brand name or, “preferred.”

Tom: The compelling aspect of Ocrevus is that, according to a 2017 Taubman Lecture by Dr. Stephen Hauser, the drug is 99 percent effective in stopping the “relapsing” form of MS. It is only 25 percent effective against the other form of MS known as “progressive.”

Also, the drug was approved by the FDA in March of 2017, so it is available. Genentech has a website with details on different ways of obtaining the drug.

Al: As encouraging as it is about Ocrevus, the benefit is that it stops one form of MS, the drawback is that there was no medication that was shown to reverse it.

In yet another clinical trial at UCSF, an over-the-counter antihistamine was shown to repair damage on myelin caused by MS.

Multiple sclerosis causes one’s immune system to attack the “insulation” or myelin around nerve fibers.

As damage to the myelin continues, the nerves increasingly lose their ability to transmit electrical signals. This is why many MS patients lose their motor functions and often their vision.

Tom: The antihistamine that was shown to reverse some of the damage to the insulation (myelin) is clemastine fumarate.

Dr. Jonah Chan, one of the co-directors of the UCSF Small-Molecule Program for Remyelination, “…demonstrated that clemastine fumarate promotes myelin regeneration and restores neural function…”.

Al: So… the next step, of course, is to go to the drug search.

There we find that Clemastine Fumarate is available as a prescription or over-the-counter. The over-the-counter version is called Dayhist Allergy and Clemastine. The cost is $18 per month for this one, and $140.65 per month for the prescription version.

More good news

Don’t forget the annual Crush MS fundraiser at Reid Family Vineyards, 1020 Borrette Lane, Napa, Saturday, July 28, from 2 to 6 p.m.

Always a good time for a good cause with wine, food, raffles, speakers and people you know.

Last year, I saw Mike Thompson, Bill Dodd, county supervisors, city council members, and famous barbecue master, Pat Burke!

Submit questions to schrette@gmail.com or alancash@gmail.com.

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