Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Attitude to reproduced disease modifying therapies in patients with relapsing-remitting multiple sclerosis: results of a medical and sociological study

Full Text:


The problem of an adequate choice of a treatment method in multiple sclerosis (MS) remains one of the most urgent in modern neurology. The number of patients and the cost of drugs are increasing, leading to an increased MS societal burden. However, treatment costs can be reduced due to the introduction of generic drugs, including domestic ones, which price is significantly lower.

Objective: to assess the attitude of Russian patients to the reproduced disease modifying therapies (DMTs) and features influencing an attitude to the replacement from the original to the reproduced drug.

Patients and methods. We interviewed 300 patients from six regions of the Russian Federation, receiving interferon beta-1a 44 μg, interferon beta-1b, glatiramer acetate, and teriflunomide, who had an experience of switching from an original drug to a domestic biosimilar drug or generic not earlier than 2009.

Results and discussion. The majority of patients (63%) do not notice any changes due to drug replacement from the original to the generic one, some (28%) experience a deterioration in their well-being, and others (7%) experience an improvement in their condition. Young patients (up to 30 years) are relatively less likely to notice a deterioration in well-being after drug replacement. The clinical deterioration after drug replacement is much more often experienced by the patients whose drug was replaced in a pharmacy (74% of cases) and not by the attending clinician (only 54% of cases of deterioration). The majority (87%) of patients with relapsing-remitting MS (RRMS) did not interrupt the treatment after replacement; 13% of respondents reported that they had stopped taking the drug. Among them, there were much more patients whose drug was replaced in a pharmacy, and not due to clinician recommendation (more than 80% of such cases). Adverse reactions to a new drug are another reason for drug withdrawal (20% of all withdrawals). Patients receiving interferon beta-1b have a higher negative attitude towards domestic DMTs: 52% of the respondents gave negative feedback (compared to 20–35% in other groups). Relatively higher loyalty to Russian DMTs was observed in patients receiving interferon beta-1a (20% of negative feedback, which is noticeably lower than in other groups) and teriflunomide (a relatively higher proportion of positive feedback to Russian drugs – 25% compared to 11–16% in other groups). The majority (76%) of the respondents noted that they are interested in learning more about the development and registration of new Russian drugs.

Conclusion. The majority of RRMS patients do not tend to have a negative attitude towards Russian DMTs. Consequently, the proportion of ratings in favor of Russian DMTs exceeds the weight of ratings against them. The key priority in the formation of loyalty to Russian DMTs should be changing the perception of adverse reactions. This will significantly increase the adherence to therapy and the quality of the provided treatment.

About the Authors

Ya. V. Vlasov
Samara State Medical University, Ministry of Health of Russia
Russian Federation

Department of Neurology and Neurosurgery

89, Chapaevskaya St., Samara 443099

M. V. Churakov
Center of Humanitarian Technologies and Research «Social Mechanics»
Russian Federation

67/69, Frunze St., Samara 443011

E. V. Sineok
Samara State Medical University, Ministry of Health of Russia
Russian Federation

Departmet of Ophthalmology

89, Chapaevskaya St., Samara 443099

A. N. Boyko
Federal Center of Brain and Neurotechnologies, FMBA of Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation

Aleksey Nikolaevich Boyko

Department of Neuroimmunology

Department of Neurology, Neurosurgery, and Medical Genetics

1, Ostrovityanov St., Build 10, Moscow 117997
1, Ostrovityanov St., Moscow 117997


1. Hauser SL, Cree BAC. Treatment of Multiple Sclerosis: A Review. Am J Med. 2020;133(12):1380-90.e2. doi: 10.1016/j.amjmed.2020.05.049

2. Kobelt G, Thompson A, Berg J, et al; MSCOI Study Group; European Multiple Sclerosis Platform. New insights into the burden and costs of multiple sclerosis in Europe. Mult Scler. 2017;23(8):1123-36. doi: 10.1177/1352458517694432

3. Boyko A, Kobelt G, Berg J, et al.; European Multiple Sclerosis Platform. New insights into the burden and costs of multiple sclerosis in Europe: Results for Russia. Mult Sler. 2017 Aug;23(2_suppl):155-65. doi: 10.1177/1352458517708668

4. Dobson R, Giovannoni G. Multiple sclerosis – a review. Eur J Neurol. 2019;26(1):27-40. doi: 10.1111/ene.13819

5. Boyko A, Melnikov M. Prevalence and Incidence of Multiple Sclerosis in Russian Federation: 30 Years of Studies. Brain Sci. 2020;10(5):E305. doi: 10.3390/brain-sci10050305

6. Gran-Ruaz S, Mani A, O'Quinn S. An overview of biosimilars and non-biologic complex drugs in Europe, the United States, and Canada and their relevance to multiple sclerosis. Mult Scler. 2017;23(14):1824-9. doi: 10.1177/1352458517739976

7. Boyko AN, Bakhtiyarova KZ, Dudin VA, et al. New pegylated interferon beta1a (sampeginterferon beta1a, BCD054) in the treatment of remitting multiple sclerosis. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2019;119(10-2):100-10. doi: 10.17116/jnevro2019119102100 (In Russ.).

8. Boyko AN, Bosenko LP, Vasilovskiy VV, et al. Efficacy, tolerability and safety of the treatment with teberif: the results of a 2-year randomized clinical trial of treatment naive patients with remitting multiple sclerosis, who have not received DMT, after switching from other interferon β-1a. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2019;119(2-2):73-85. doi: 10.17116/jnevro20191192273 (In Russ.).

9. Boyko AN, Lashch NYu, Sharanova SN, et al. Comparative, placebo-controlled clinical study of efficacy and safety of glatiramer acetate 20 mg in patients with relapsing-remitting multiple sclerosis: results of the first year of the study. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2016;116(10-2):61-7. doi: 10.17116/jnevro201611610261-67 (In Russ.).

10. Boyko AN. Clinical effects and tolerability of high-dose, high-frequency recombinant interferon β-1a in patients with multiple sclerosis: maximizing therapy through long-term adherence. Expert Opin Biol Ther. 2010 Apr;10(4):653-66. doi: 10.1517/14712591003702361

11. Neter E, Glass-Marmor L, Wolkowitz A, et al. Beliefs about medication as predictors of medication adherence in a prospective cohort study among persons with multiple sclerosis. BMC Neurol. 2021;21(1):136. doi: 10.1186/s12883-021-02149-0

12. Menzin J, Caon C, Nichols C, et al. Narrative Review of the Literature on Adherence to Disease-Modifying Therapies Among Patients with Multiple Sclerosis. J Manag Care Pharm. 2013;19(1 Supp A):S24-S40. doi: 10.18553/jmcp.2013.19.s1.S24

13. Giovannoni G, Southam E, Waubant E. Systematic review of disease-modifying therapies to assess unmet needs in multiple sclerosis: tolerability and adherence. Mult Scler J. 2012;18(7):932-46. doi: 10.1177/1352458511433302

14. Usherwood T. Encouraging adherence to long-term medication. Aust Prescr. 2017;40(4):147-50. doi: 10.18773/austprescr.2017.050

15. Lam WY, Fresco P. Medication Adherence Measures: An Overview. Biomed Res Int. 2015;2015:217047. doi: 10.1155/2015/217047. Epub 2015 Oct 11.

16. Cramer JA, Roy A, Burrell A, et al. Medication compliance and persistence: terminology and definitions. Value Heal. 2008;11(1):44-7. doi: 10.1111/j.1524-4733.2007.00213.x

17. Hugtenburg J, Timmers L, Elders P, et al. Medication adherence: WHO cares? Mayo Clin Proc. 2011;86(4):304-14. doi: 10.4065/mcp.2010.0575


For citations:

Vlasov Y.V., Churakov M.V., Sineok E.V., Boyko A.N. Attitude to reproduced disease modifying therapies in patients with relapsing-remitting multiple sclerosis: results of a medical and sociological study. Neurology, Neuropsychiatry, Psychosomatics. 2021;13(1S):50-56. (In Russ.)

Views: 274

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)