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When the American Academy of Neurology (AAN) published its five “Choosing Wisely” recommendations earlier this year, recommendation No. 4 was the following: “Don’t prescribe interferon-β or glatiramer acetate [Copaxone, Teva] to patients with disability from progressive, nonrelapsing forms of multiple sclerosis.”

Several prominent neurologists with expertise in MS criticized the recommendations soon after they were published online in the Feb. 20, 2013 edition of Neurology (doi: 10.1212/WNL.0b013e31828aab14). The specialists clearly were miffed at the proscription against the two injectable MS drugs, posting multiple comments on the “WriteClick” section of Neurology’s website. “This is an oversimplified recommendation that we strongly feel needs to be more nuanced,” argued representatives of the AAN’s Multiple Sclerosis Working Group. “Progressive MS patients with superimposed relapses can still benefit from these agents.........” - Read More - http://www.ms-uk.org/index.cfm/MSnews

Always teetering on the dotted line between wanting to slow down progression as effectively as possible and the "We need a new market to shill this drug to, go cook up some new 'research'" mentality.

Luongo, as concerns your statement. "We need a new market to shill this drug to," and its application to dimethyl fumarate, long used to treat psoriasis:
http://www.alibaba.com/product-gs/36632 ... arate.html
From the chemical company at the posted website, 98% dimethyl fumerate may be purchased for $1 - $50/metric ton. Assuming the average cost of $25/metric ton, and given that:
1 metric ton = 1000 kilograms = 1,000,000 g, and at the recommended dosage, the total quantity of the actual drug is
(240 mg / dose) x (2 doses / day) x (365 days / year) = 175, 200 mg / year = 175 g / year, the cost to Biogen for one patient’s yearly supply is $0.004375: less than half a penny per year (that's per year, not per dose). If the quality from this company is an issue (I don’t know if it is), you can buy 98% pure dimethyl fumerate from Chemreagents for $64/500g. A lot more expensive, but still only about $25/year (175 g/yr x 3 yr = 525 g).
From Forbes, http://www.forbes.com/sites/johnlamatti ... new-drugs/: "A clear demonstration of this occurred last week with the approval of Biogen Idec’s new drug for multiple sclerosis (MS), Tecfidera. As reported by Matt Herper, Biogen Idec has priced this drug at $54,900 per patient per year – between the prices of the other MS drugs, Novartis’ Gilenya ($60,000 per patient per year) and Sanofi’s Aubagio ($51,000 per patient per year). Biogen Idec believes that at its price it “represents a solid value to the MS community” in terms of efficacy and ease of administration. The active ingredient of Tecfidera is dimethyl fumarate, a chemical that organic chemists like myself use commonly in lab experiments. It should be noted that one can buy dimethyl fumarate from chemical suppliers for $56.20 per 1000 grams!"

And some people over the years have accused me of having an agenda against the drug companies that produce these medications for MS!! Some things in the MS world of medicine never seem to change.

Harry