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Multiple Sclerosis Centers of Excellence


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MSCOE Newsletter Announcement

MS Veteran Newsletter

Discusses symptom management, medications, and living well with MS. Check out our latest issue!

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Get Out and Play

Get Out & Play

Adaptive sports can help keep you in the game. No matter your skill level, there is a sport for you.

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MS Education and Awareness

March is MS Education and Awareness month. Learn how you can get involved and raise MS awareness!

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Multiple Sclerosis Centers of Excellence

The Multiple Sclerosis Centers of Excellence are dedicated to furthering our understanding of multiple sclerosis (MS), its impact on Veterans, and effective treatments to help manage MS symptoms. By partnering with Veterans, caregivers, health care providers, and other service organizations we hope to minimize impairment and maximize quality of life for Veterans with MS.

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MSCoE East and West have developed a national network of MS Regional Programs and MS Support Programs within the VA.

Given the size of the population of Veterans with MS seeking treatment in VA and their distribution across the country, it is feasible to provide access to high quality subspecialty care through a hub and spoke network with designated MS Regional Programs supporting local facilities.

Each Veterans Integrated Service Network (VISN) will have at least one MS Regional Program that will serve as a source for MS specialty consultation and education. The primary care for individuals with MS will occur at their local VA medical facilities. MS Support Programs will collaborate with local MS Regional Programs. The MS Care Liaison at VA medical facilities with an MS Support Program will assist with coordination and referrals to the MS Regional Program as needed.

white figure talking through microphoneAnnouncements

April 5, 2018

There is now a generic glatiramer 40 mg 3x week product available from Mylan. There are some facilities and Consolidated Mail Outpatient Pharmacies (CMOPs) which have begun a therapeutic interchange with this product from the branded Copaxone® product. The National Pharmacy Benefits Management Services (PBM) is working with the field to improve the communication thread on this interchange. To decrease the number of potential interchanges a patient may have, PBM and CMOP have agreed to use the Sandoz product for glatiramer 20 mg dose and the Mylan product for glatiramer 40 mg dose.

There are patient and provider letters regarding this therapeutic interchange. They can be found at Clinical Guidance Patient and Provider Letters. The provider letter notes the GATE TRIAL in JAMA Neurol. 2015; 72(12):1433-1441 which should be reviewed. This study was conducted using the Synthon/Mylan product.

Veterans will need to have the corresponding auto injector for the product dispensed. All the auto injectors are available from the CMOP. If you cannot identify which product to order, please contact your pharmacy and they can help you. The field has been provided the ordering information for each injector and have been provided education regarding each product requiring a specific auto injector. Information from the FDA on the approval process for generic drugs may help in understanding the generic approval process. Both generic glatiramer products have product support programs in place.

March 29, 2018

The MS Team at the Madison, WI VA hosted a table for MS Awareness Month. Thank you for all that you do for Veterans in your area and for being a part of the MSCoE Network!

picture of table with MS flyers

March 26, 2018

In November 2017, Zostavax was removed from the VA National Formulary and was replaced with Shingrix. Here is a short summary: (1) Shingrix is more effective than Zostavax in preventing cases of herpes zoster (shingles); (2) Shingrix contains an 'adjuvant', boosting vaccine effectiveness while Zostavax does not; (3) Shingrix is NOT a live vaccine, unlike Zostavax, which is live; (4) Shingrix does NOT need to be stored frozen while Zostavax needs to be stored in the freezer; (5) Shingrix is given via an intramuscular injection while Zostavax is given via a subcutaneous injection; and (6) Shingrix is given as a two dose series, with doses spaced 2 to 6 months apart while Zostavax is given as a single dose. Since Shingrix is not a live vaccine, its use should be safe in people with MS, including those on immunosuppressive and B-cell depleting therapies (rituximab, ocrelizumab). 

The efficacy of Shingrix in people on B-cell depleting therapies in not known but may be reduced. When possible, complete the Shingrix series prior to starting immunosuppressive or B-cell depleating therapies in people with MS.

FAQ document from VHA PBM
VHA PBM Criteria for Use

March 3, 2018

There is a voluntary withdrawl of daclizumab (Zinbryta®) from the market.

March 1, 2018

Visit the VA Blog to read Army Veteran Crystal Muscatello's story about living with MS.

January 30, 2018

Join MSCoE at the Consortium of MS Centers Annual Meeting in Nashville, TN May 30 - June 2, 2018.

January 4, 2018

The National Veterans Wheelchair Games are in Orlando, FL July 30 - August 4, 2018.