Anyone in Canada covered for Rituxmab?

[mum2kat+3]

My neurologist wants to start me on Rituxmab. My husband and I have the same Extended medical company with our employers. On their website it is listed as a covered drug for rheumatoid arthritis but my Neuro raved about it for MS and said it would be a great drug for me to reduce flares.
The other thing is he has not diagnosed me with MS, only Recurrent transverse myelitis.

Wondering if any others have dealt with insurance on this drug?

Thanks

[agate]

Sorry I don't know much about Canada or Rituximab but I wonder if your neuro has changed your diagnosis to MS? If the plan is to prescribe it, you might want to ask.

Doctors can often prescribe a drug for "off-label" use if they want. Or at least they can in the US.

I noticed that there's a new study of Rituximab for SPMS starting up. This description of the study from the National MS Society Webpage gives some information about the drug:

Apr 15, 2013
Summary:

Researchers at the National Institutes of Health in Bethesda, Maryland are looking to recruit 80 people with secondary-progressive Multiple Sclerosis (secondary-progressive MS) to evaluate the safety and effectiveness of rituximab. Rituximab is an experimental drug for treating MS. In this study it will be given intravenously and directly into the cerebrospinal fluid by lumbar puncture (“spinal tap”).

The study is funded by the National Institute of Neurological Disorders and Stroke.

Rationale: MS is an inflammatory disorder that progressively weakens and destroys the pathways of the nervous system. Secondary-progressive MS begins with an initial relapsing-remitting disease course, followed by progression of disability that may include occasional relapses and minor remissions and plateaus. There are currently no effective treatments for people with secondary-progressive MS who do not experience relapses or who do not have “active” lesions on MRI.

Under normal conditions, the blood brain barrier separates the brain and spinal cord from the bloodstream and limits what can gain access to the nervous system. In active stages of MS, the inflammation in the brain and spinal cord leads to breakdown of this barrier. This break-down allows MS medications to reach the brain and spinal cord without being screened out. In people with secondary-progressive MS who do not have “active” disease, the blood-brain barrier is intact.

Drugs that could stop the inflammation simply cannot reach the areas of the brain and spinal cord where they are needed.

Researchers want to understand whether the drug rituximab, which is used to treat rheumatoid arthritis and some types of cancer, is able to slow down or stop the progression of secondary-progressive MS. In people with earlier, active disease, this drug can stop inflammation in the brain. However, intravenous rituximab did not help people with primary-progressive MS, possibly because the drug could not get through the intact blood-brain barrier. In this new trial, to ensure that the rituximab will reach the brain and spinal cord in people with secondary-progressive MS, participants will receive it intravenously and by injection through a lumbar puncture into the cerebrospinal fluid (“spinal tap”).

...
The study will last 3 years and will be divided into two parts. The first part is a 1-year baseline period during which participants will not be treated. The second part is a 2-year treatment period during which there will be a total of 3 infusions with either rituximab or placebo. Participants will have periodic follow-up clinic visits that will include brain magnetic resonance imaging (MRI) scans, blood tests, and other evaluations. There will be approximately 7 outpatient clinic visits. Outpatient clinic visits will last 2-5 hours. The 3 infusion visits will each require a 2-3 day admission to the NIH Clinical Center.
There is no cost to take part in this study. Reimbursement for travel, lodging, and food will be offered. People in the study will not receive payment.

The primary outcome measure is to determine whether rituximab can decrease brain atrophy – loss of brain tissue volume – significantly more than placebo.
...

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