Date:6/1/2011

ation process.  Neurologists described an overwhelming degree of red tape affiliated with the reimbursement of Ampyra.  Of surveyed Ampyra prescribers, 40% reported reimbursement issues with the drug.  Unlike Gilenya, Ampyra's launch appears to be greatly hindered by these issues.  Since neurologists view Ampyra's efficacy as questionable and limited to a niche subset of the MS population, they seem less willing to jump through hoops to get patients on it.  The difference in how neurologists are handling Gilenya versus Ampyra is indicative of the cost-benefit analysis that is inherent in every treatment decision.  Neurologists have made more of a commitment to Gilenya because they believe it can deliver meaningful benefits to their patients and Novartis is facilitating the delivery of those benefits.  This hasn't been the case with Ampyra.  Data from ITG's proprietary physician panel have pointed to waning demand for Ampyra, which the study concludes is unlikely to improve without material changes to the drug's reimbursement situation.

Conducted in April - May 2011, the study includes analysis of a targeted Internet survey of 100 neurologists and proprietary longitudinal treatment data from a panel of 225 neurologists spanning 2005-2011. Through triangulation of quantitative and qualitative findings from these two data sources, the report provides an in-depth look at the launch of Gilenya and the potential for future oral disease-modifying drugs in the multiple sclerosis market. In addition, the report evaluates uptake and use of Acorda Therapeutics' Ampyra as a supportive agent in the MS space.

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