Searching for the “Active Ingredients” in Physical Rehabilitation Programs Across Europe, Necessary to Improve Mobility in People With Multiple Sclerosis: A Multicenter Study

Background. Physical rehabilitation programs can lead to improvements in mobility in people with multiple sclerosis (PwMS). Objective: Identify which rehabilitation program elements are employed in real life and how they might impact mobility improvement in PwMS. Methods. Participants were divided into improved and non-improved mobility groups based on changes observed in the Multiple Sclerosis Walking Scale-12 following multimodal physical rehabilitation programs. Analyses were performed at group and subgroup (mild and moderate-severe disability) levels. Rehabilitation program elements included: setting; number of weeks; number of sessions; total duration, therapy format (individual, group, autonomous), therapy goals and therapeutic approaches. Results. The study comprised 279 PwMS from 17 European centers. PwMS in the improved group received more sessions of individual therapy in both subgroups. In the mildly disabled group, 60.9% of the improved received resistance training, whereas, 68.5% of the non-improved, received self-stretching. In the moderatelyseverely disabled group, 31.4% of the improved, received aerobic training, while 50.4% of the non-improved, received passive mobilization/stretching. Conclusions. We believe that our findings are an important step in opening the black-box of physical rehabilitation, imparting guidance and assisting future research in defining characteristics of effective physical rehabilitation

Generic medicines and biosimilars: Impact on global pharmaceutical policy

Patient access to safe and cost-effective treatment is an important goal for the healthcare system. The development of biosimilar compounds and generic medicines is interesting to the industry and society to reduce healthcare costs, fulfill the needs of healthcare stakeholders and potentially increase accessibility to patients. Patient and physician acceptance, with many patients preferring biologics and branded products and physicians prescribing the same, limits the use of generic medicine and biosimilars. The growth of these products in part depends on various stakeholders' decisions to provide, pay for or use these products in a safe and thoughtful manner. Ongoing stakeholder collaboration, educational activities and review of current government and payer policies are required to optimize the uptake of generic medicines and biosimilars.Scopu