Ampyra (dalfampridine)

[spacecowgirl]

Just had a patient in the hospital on it (home supply, thank goodness). Even though it's been out almost 2 years, I had never seen it used. Seems like a load of hooey to me. Has a REMS program (seizure risk). Cost >$1,000/month which is cheaper than injectables.

It "significantly" improves walking speed by 25%, which amounted to something like 0.88 sec improvement in walking 25 ft.

Have you seen it? Know anything about it?

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[lorain]

its a joke

i know neuros who dont even allow ampyra reps into their offices b/c its such a travesty

however, you can cover the drug provided the initial walk is documented, a neuro is prescribing it, a baseline wak + and in 3 months the walk has improved....so for ex, if they have primary progressive MS, for which the modifying agents arent indicated, its conceivable the pt be given this to help them out

 

[psychoandy]

Niche drug for MS, works for some but not too effective imo. more of an adjunct agent on top of glatiramer or ifn. It used to be compounded for much cheaper but now is hella expensive.

For inpt hospitalization I would have no issues holding drug, and if they're having a flare they can get some methlpred.

 

[p-rog]

Niche drug for MS, works for some but not too effective imo. more of an adjunct agent on top of glatiramer or ifn. It used to be compounded for much cheaper but now is hella expensive.

For inpt hospitalization I would have no issues holding drug, and if they're having a flare they can get some methlpred.

I did a rotation last year at an independent pharmacy inside a spinal cord injury hospital that was compounding it for like $50/month for their MS patients. Every now and then, the insurance would reject and say that we should give the patient the commercially available drug (at a 20-fold increase in cost), so stupid.

 

[psychoandy]

I did a rotation last year at an independent pharmacy inside a spinal cord injury hospital that was compounding it for like $50/month for their MS patients. Every now and then, the insurance would reject and say that we should give the patient the commercially available drug (at a 20-fold increase in cost), so stupid.

i know, it's ridic, especially when i had pts whose insurance would not cover Ampyra and they would pay 1500 bucks for a months supply just to try it and were so desperate for anything. i mean, it was nice that they cared enough about their health while most ppl balk at a 30 dollar copay, but still that was a bit much. technically i think compounding fampridine now would be prohibited by FDA since you're compounding a commercially available product but who knows, i'm sure places are skirting the rules.

speaking of novel MS therapies, i'd like to know how fingolimod is doing. i'm sure it's a 2nd line PA-requiring therapy but that just came out pretty recently as well. PO therapy is huge for MS, but i'm sure the cost is ridic and there was some issue where new starts had to be watched for bradycardia, but we weren't sure where to do it logistically, e.g. hang out in the ED for 6 hours on tele.

 

[Ackj]

When we learned about it in neuro, we were taught that it didn't really improve your walking. You would still shuffle, but just shuffle a little quicker. Can't see the point of it really, because you probably aren't rushing around anyway.