• Disease-modifying therapies (DMTs) can reduce the frequency and severity of relapses and slow the progression of disability and new brain lesions in multiple sclerosis (MS) patients.
• DMTs’ use changed significantly over the past decade, thanks to new, higher-efficacy drugs.
• DMT claims grew by half between 2010–18. Reimbursement costs also rose, from $386.9 million in 2010 to $607 million in 2018.
• Over half of DMTs are claimed through private drug plans. Seven per cent are paid for out-of-pocket. In 2018, this represented $39.3 million in spending for individuals and their families.
• Families affected by MS face a greater financial burden than the average Canadian household. And out-of-pocket costs vary by treatment, province, and drug coverage.
• Public access to new, innovative DMTs lags behind private drug coverage access.
• Timely, affordable, and equitable access to DMTs will lead to better outcomes. Health systems and society at large also stand to gain.

Highlights

Multiple sclerosis in Canada

Accessing prescription drugs: challenges faced by Canadians

Utilization and cost of DMTs in Canada

Innovative medications

Symptom management and costs

Comparing the out-of-pocket burden of other conditions

Impact of COVID-19 on private drug coverage

An illustration: accessing DMTs within a changing treatment landscape

Economic impact of appropriate DMT use

Conclusion

Appendix A—Methodology

Appendix B—Definitions

Appendix C—Disease-modifying therapies for multiple sclerosis treatment

Appendix D—Provincial drug plans for people living with multiple sclerosis

Appendix E—Out-of-pocket spending case study

Appendix F—Bibliography