Multiple sclerosis is a degenerative condition that affects hundreds of thousands of adults in the United States alone, and while no cure is known for the disease currently, significant progress has been made in terms of treatment. Seniors often suffer the most from multiple sclerosis because of failed treatment methods in the past, leading many older adults to have developed debilitating effects over the course of a lifetime.
Thankfully, seniors affected by multiple sclerosis today can benefit from new treatments, including medications like Ocrevus, that may slow down the progression of multiple sclerosis, restore function to damaged nervous system components and possibly heal damaged tissue.
What is Ocrevus?
Ocrevus, the brand name for ocrelizumab, works as an antibody at the cellular level to target and isolate specific B cells that contain the CD20 protein. Such cells are thought to be responsible for the development of multiple sclerosis and the worsening of its symptoms.
By isolating that CD20-containing B cells, the remaining B cells without the CD20 protein are able to function normally in a healthy immune system, thereby reducing attacks on the nervous system and potentially restoring function to damaged areas. Currently, the exact mechanism by which Ocrevus works is unknown, but the proposed mechanism of action has been shown in testing to be sound, and the drug has been cleared by the U.S. Food and Drug Administration.
Does Medicare Cover Ocrevus?
Ocrevus is not currently covered by Medicare Part D prescription drug coverage. Ocrevus is administered as an injection that infuses the body’s blood with the drug. As a result, Ocrevus is not available through retail pharmacy locations and can’t be self-administered. Furthermore, testing may need to be completed prior to starting Ocrevus, and patients taking this medication will often need to undergo extended monitoring to ensure the proper dosage and frequency of administration.
Although Part D does not cover Ocrevus, some Medicare recipients may be able to receive coverage for the drug when it is deemed medically necessary and is administered by a physician or skilled nursing professional. This may happen in a certified skilled nursing facility or in an outpatient clinical setting, allowing for potential coverage under Medicare Parts A and B respectively. Coverage may also be granted incident-to a hospital stay after an emergency. Medicare Advantage plan members will have at least the same Part A and Part B benefits as Original Medicare, but many offer additional coverage.
While Ocrevus has shown promise as an effective measure to fight multiple sclerosis, it is not the only therapy available. In fact, there are alternative medications and therapies.
Your situation and treatment options may also be affected by other medical conditions that require a thorough analysis by your physician in order to ensure each therapy complements the other. As with all medical conditions, discuss any and all medications and supplements you are currently taking as well as any health concerns you have with your doctor prior to considering treatment with a new prescription.