Betaseron — Medica
relapsing forms of multiple sclerosis (clinically isolated syndrome, relapsing-remitting disease, or active secondary progressive disease)
Initial criteria
- Patient has a relapsing form of multiple sclerosis (clinically isolated syndrome, relapsing-remitting disease, or active secondary progressive disease); AND
- Medication is prescribed by or in consultation with a neurologist or a physician who specializes in the treatment of multiple sclerosis
Reauthorization criteria
- Patient has a relapsing form of multiple sclerosis (clinically isolated syndrome, relapsing-remitting disease, or active secondary progressive disease); AND
- Patient experienced a beneficial clinical response when assessed by at least one objective measure (e.g., stabilization or reduced worsening in disease activity by MRI, stabilization or reduced worsening on EDSS score, achievement in NEDA-3 or NEDA-4, improvement on fatigue or walking scales, improved MSFC score, or attenuation of brain volume loss) OR patient experienced stabilization, slowed progression, or improvement in at least one symptom (such as motor function, fatigue, vision, bowel/bladder function, spasticity, walking/gait, or pain/numbness/tingling); AND
- Medication is prescribed by or in consultation with a neurologist or a physician who specializes in the treatment of multiple sclerosis
Approval duration
1 year