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Comment by colechristensen | Hacker News Reader

Where isn’t this true unless you’re rich and connected?

Australia? MS clinics around the country are free under Medicare, as is treatment. My friend is receiving twice annual infusions of Ocrelizumab. It literally costs them nothing.

I mean you can argue that Australia is a rich country, but it’s available to any citizen regardless of wealth.

You first need to get someone to prescribe Ocrelizumab

That really was not a problem.

https://www.msaustralia.org.au/news/subsidy-recommendations-...

It's not available if you have early, MRI-active primary progressive MS. PBAC decided not to reimbursement ocrelizumab for that.

Many if not most countries have preferred front-line treatments, usually decided by a combination of overall costs. These costs will include things like actual monetary cost, how closely you need to be monitored by your doctors (blood tests and stuff), how severe side effects are, how much the reduce disability in the long term, the ability of patients to stick with it and things like that.

Right. And some countries choose to have first-line treatments that prioritize lower cost over efficacy of therapy. It's great as a taxpayer, not so great at a patient.

Some countries prescribe Rituximab as quasi off-label for MS. Basically same drug for all intents and purposes as Ocrevus.

I think Sweden uses Rituximab openly for MS. In the US I've heard some neuros prescribe Rituximab if insurance won't cover O.

Rituximab was shown to be inferior in a head to head comparison against ocrelizumab.

Most of europe

In most parts of Europe getting to a specialist (e.g. a neurologist in this case) may still involve a long wait.

That’s because people trust their gp; if you don’t, you get referred fast. At least where I have lived and I am on public healthcare; experience with NL ES PT UK BE; never have to wait for anything.

No, in Poland it’s because there is simply a long wait for on and not because people trust their gp (quite the opposite in many cases)

That's the case in many places of the US as well.

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