Life with MS & EDS

January 6, 2009

Decision Time

Tomorrow is my neurology appointment and it’s time to pick a medication. I’ve done the evaluation of the 4 Multiple Sclerosis drugs I was given the choice of: Avonex, Betaseron, Copaxone, and Rebif. I’ve check out their websites, watched their promotional DVDs, read their packets, and surfed around online to see what others had to say.

Before I continue, you should know I’m a project manager by trade. To be more specific, I’m an IT Portfolio Management Specialist. For most of my career I’ve done things such as evaluate projects, set scoring criteria, and provide data to senior leadership for decision-making. So, I’m trained to do research, create a scoring model, and assess alternatives against the criteria. What better way to think through this decision that to do the same thing here.

I have an old version of a decision-support tool which I used to create a model with four criteria and then compared their importance against one another. Here’s how it turned out:

Priority Graph

Priority Graph

Some of the text cut off. The first two are “Can tolerate short-term side effects” and “Can accept long-term side-effect risks.” In case you can’t see the graphics, the last two are “Number of shots” and “Ease of doing the injections.”  Drug efficacy was not considered because they all seem relatively equally effective in studies and therefore that wouldn’t differentiate the drugs in any meaningful way.

A bit too anal-retentive of me? Then I rated each drug against the criteria and here’s what I came up with:

Alternatives Graph

Alternatives Graph

There’s a lot of data behind this chart, but obviously Copaxone is way out in front. If you’ve been reading the other posts, you probably already figured out that I was leaning towards Copaxone. It really comes down to the side effects. While Copaxone obviously scored lowest in number of shots (daily injections), which I thought would be my main consideration before doing the research, it turns out that was the least of my concerns. Quality of life turns out to be much more important. The last thing I want to deal with is flu-like symptoms (even if they do subside after a period of time) or depression and I certainly don’t want to worry about the risk of long-term side effect like liver disease or thyroid issues, both of which already run in my family. So that rules out all of the Interferons (Avonex, Betaseron, and Rebif) and the only one left standing is Copaxone.

I’m looking forward to seeing what the neuro has to say tomorrow. Wish me luck! If you see this before mid-morning tomorrow and have suggestions for questions I should ask him, please let me know.

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5 Comments »

  1. Hmmmmm….other questions, or criteria to consider. How do the drugs rank in patient compliance (strictly following treatment plan) or evidence of benefit (fewer lesions, fewer relapses, slowed disease progression, delayed transition to SPMS) or rate of ‘failing’ treatment and needing to switch after some time?

    I love your decision tool by the way. Not ‘anal’ at all, just smart and organized (at least in my book, lol). Good luck at the neuro’s tomorrow.

    Comment by Lisa Emrich — January 6, 2009 @ 10:44 pm

  2. […] talked about the various medications and I explained why I was leaning towards Copaxone. He did say that the interferon companies will say that it isn’t as effective as their […]

    Pingback by To Wait or Not to Wait… « Life with MS & EDS — January 7, 2009 @ 1:04 pm

  3. Thanks, Lisa! Do you happen to know of a reliable, nonpartisan information source that discusses any of these factors?

    Comment by mseds — January 7, 2009 @ 1:07 pm

  4. Off the top of my head, I can’t reference a nonpartisan site with information comparing drugs. I think this would be a good research project, one which includes information collected in the past 10-15 years (not just from the original studies.) Have to look into this. 🙂

    Comment by Lisa Emrich — January 10, 2009 @ 7:00 pm

  5. It would be great to have that kind of reference around. It would certainly be fun to research.

    Comment by mseds — January 10, 2009 @ 7:26 pm


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