We thank Kern et al. and Phillips for their constructive critiques of our article. While they have highlighted the inherent limitations of developing consensus statements by payers for payers, we feel that they have slightly, but importantly, misinterpreted the purpose of our work. As stated in our article, the multiple sclerosis (MS) consensus statements were intended "to serve as a practical reference tool for health plans, to be used in conjunction with clinical evidence, when designing benefits and coverage policies for MS agents." We appreciate the not-infrequent clinical scenario described by Phillips and the feedback concerning the limitations of consensus statement 21. We agree that a patient with either secondary-progressive MS without relapses or primary-progressive MS who is no longer taking 1 of the disease-modifying agents needs a symptomatic treatment option.
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