Public consultation now closed: Guidelines for essential disease-modifying therapies for multiple sclerosis for low-resource settings

There are 2.8 million people living with MS but many people do not have access to disease modifying therapies (DMTs). 20 different DMTs have been approved by the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA) for MS as of 2022. Yet access to DMTs is subject to a country’s healthcare system and whether someone can pay for services. The Atlas of MS shows that in 70% of countries people with MS face barriers in accessing DMTs. Accessing the right MS treatment depends on whether:

• people have access to healthcare
• the healthcare system will pay for MS care (e.g. diagnosis and treatment)
• a range of DMTs are available and covered by the healthcare system
• there is a continuous and reliable provision of treatment.

It is vital for people with MS to get the right treatment at the right time. That’s why MSIF wants to provide evidence-based guidelines for essential medicines that should be available to everyone with MS in low-resource settings.

To approach this task, MSIF established an independent MSIF Essential Medicines Panel (MEMP). This panel was international, multi-disciplinary and included people affected by MS from Uruguay, Serbia, Namibia and Morocco. We also partnered with the Cochrane MS group and McMaster GRADE Centre during this process, both groups being internationally regarded as experts in the field of evidence reviews and decision-making.

The panels were tasked with reviewing DMTs for MS: all DMTs that have regulatory approval, as well as some DMTs that are used ‘off-label’. Read more about MSIF’s Off-Label Treatments recommendations for low-resource settings here. The panels considered DMTs for relapsing and progressive MS.

The recommendations are specifically aimed at low-resource settings where a range of DMTs are not available and affordable. Low-resource settings include low- and middle-income countries and disadvantaged populations in high-income settings, e.g. uninsured, refugees.

The recommendations were open for public comment until 27 January 2023. A summary of comments received, as well as responses to these comments, is now available.

The draft recommendations are available here.

In addition, we have prepared:

• A scope document explaining the purpose of the recommendations.
• A Frequently Asked Questions (FAQs) document to give more context to the recommendations.

If you have any questions, please contact Joanna Laurson-Doube: joanna@msif.org