Q&A: Medication Challenges and the Pharmacist’s Role in Multiple Sclerosis Care

In this Q&A with Pharmacy Times®, Kiranpal Singh Sangha, PharmD, discusses common medication-related challenges faced by patients living with multiple sclerosis, including adherence issues and treatment-related side effects. He explains that these challenges can be particularly pronounced with oral therapies and highlights the importance of educating patients early about what to expect from their medications. Singh Sangha also notes that patient preferences vary, with some favoring self-administered therapies and others opting for infusion treatments they perceive as more effective. He emphasizes the critical role pharmacists play in educating patients on dosing, administration, storage requirements, and the most relevant side effects. Additionally, Singh Sangha underscores the importance of preparing patients for insurance-related barriers, such as prior authorization, and encouraging open communication about disease progression and when to contact their health care providers.

Pharmacy Times: What are some common medication-related challenges you see among patients living with multiple sclerosis?

Kiranpal Singh Sangha, PharmD: Some of the challenges I see in patients who live with multiple sclerosis are compliance issues, which are definitely challenging, especially for patients who are taking oral therapies. Other challenges I see are specific side effects. Every medication has different types of side effects, so I think educating patients in advance is very useful. Other challenges include that some people are more interested in therapies that they have more control over. For example, they may want an oral therapy that they can take or a self-injection, whereas others want treatment that they feel has the strongest effects. They may lean toward an infusion type of treatment.

Pharmacy Times: How do pharmacists help patients navigate complex MS treatment regimens and insurance requirements?

Singh Sangha: The pharmacist can help patients navigate MS treatments, but I think the most important role is education about the treatment, including storage requirements, dosing, administration, and possible side effects to expect. Every medication can have a lot of potential side effects. I suggest that a pharmacist at least mention the top three to five side effects of the medication, because some have a long list of side effects. In terms of insurance requirements, that can be quite a process depending on the medication selected for the patient. Educating patients in advance that, for example, if a medication requires insurance prior authorization, that process can take time.

Pharmacy Times: What advice do you have for pharmacists looking to better support patients with MS in everyday practice?

Singh Sangha: To better support patients with MS, I think pharmacists should be knowledgeable about the treatments being offered, including storage requirements and education about medication side effects, at least the common side effects to expect, as well as any insurance barriers. When I see my patients, I personally talk to them upfront about potential insurance requirements that we may have to navigate. I also talk to them about the disease state, outcomes to look for, and when to contact their providers.