By: Sruthy Iype  Sep. 10, 2020

Dexur’s analysis of Medicare claims data showed that Ocrevus is used in twice as many multiple sclerosis patients as compared to Tysabri. The analysis looked at the J code usage of the drugs (J2350/J2323) among Medicare patients who received treatment in hospital outpatient settings between Jan 2018 and Dec 2019. The analysis also looks at the average claims per patient data, which is a proxy for the number of injections / IV infusions / doses administered to a patient.

Multiple Sclerosis (MS) is a condition affecting the central nervous system (brain and spinal cord) in which the immune system attacks the myelin sheath insulating the nerve cells and disrupts the transmission of signals between the brain and the rest of the body. The symptoms vary widely from person to person and commonly include muscle weakness, coordination and balance problems, tingling and burning sensations, numbness, fatigue, chronic pain, and vision problems.

Ocrevus (ocrelizumab) and Tysabri (natalizumab) are monoclonal antibodies used as disease modifying therapeutics in the treatment of multiple sclerosis. While both are indicated for relapsing-remitting forms of MS (RRMS), Ocrevus is also approved by the FDA for Primary Progressive Multiple Sclerosis (PPMS). Developed by Genentech, Ocrevus binds to the CD20-positive B lymphocytes (B-cells are involved in multiple mechanisms responsible for the pathogenesis of MS) and kills them. Biogen’s Tysabri is an integrin receptor antagonist that blocks the entry of leukocytes into the central nervous system. The reduced inflammatory response, thereby helps in the reducing the number of lesions in MS patients and results in fewer relapses. Apart from MS, the drug is also approved for the treatment of Crohn’s disease.

The share of MS patients who were treated with Ocrevus was significantly higher as compared to Tysabri during both years of the study. The proportion of patients who were administered Ocrevus was 1.8 times that of Tysabri in 2018, whereas in 2019 the patient-share of the former was 2.4 times that of the latter. This indicates widening of the gap between the usage of the two drugs across the two years. MS patients had an average of 7.7 claims per year for Tysabri and a significantly lower 1.8 claims per year for Ocrevus. The marked difference in average usage per patient can be attributed to the difference in dosage for the two drugs. While Tysabri is administered once every four weeks, Ocrevus is administered only once every six months following the starter dose taken two weeks apart.