Fact Sheet: Amyotrophic Lateral Sclerosis Findings in JMCP

FINDINGS FROM THE AMCP MARKET INSIGHTS PROGRAM | June, 2023

Summary 

Patient representatives emphasized the diverse range of ALS experiences and challenges with timely access to ALS medications and DME. Actions encouraged by panelists included rethinking payer authorization processes, increasing collaboration across internal departments and with providers, and utilizing PIE for drugs under investigation for progressive and fatal diseases. It is also important for the AAN to update their practice guidelines for ALS to include best practices for diagnosis and recommendations for new drug therapies as payers consider clinical guidelines in their coverage decisions and utilization tools. The differences between the clinical trial environment and real-life patient experience also deserve consideration when developing formulary management strategies and should consider provider burden and the progressive and varied nature of ALS. Finally, care and benefit coordination for patients with ALS is vital in making progress toward ensuring optimal patient outcomes and lowering overall cost of care. Payers can look to the example framework to improve appropriate access to ALS treatments and other quality improvement programs to identify simple steps to improve benefit coordination and the quality of care for patients with ALS.

View Findings in JMCP