Wednesday, 1 October 2014

Availability of Disease-modifying therapies for MS: a global perspective 

The MSIF (Multiple Sclerosis International Federation) published in 2013 Atlas of MS, an update on an earlier version published in 2008. The objective was to basically get an update on the global prevalence of MS, resources and services distributed by country.

Below is the global prevalence of MS by country (an estimation only); this number has increased from 2.1 to 2.3 million. This is partly due to the increased survival of the world population, but may also be due to better diagnosis and reporting of MS. You'll see that most of Sub-Saharan Africa did not provide any data.

In 96% of HIGH INCOME countries, the cost of 1st line DMTs (disease modifying therapies: interferons and glatiramer acetate) were either fully or partly-funded by the government - I refer to our UK risk-sharing scheme. This figure sharply drops to 45% in the LOWER MIDDLE INCOME countries and 0% in the LOW INCOME COUNTRIES. Access to more active therapies, such as natalizumab and fingolimod, also appears to be only an option for the privileged. When asked why, 86% of the lower and lower middle income countries listed affordability as the most common reason. This is a post-code lottery on a global scale.

"I am a poor man, but I have this consolation: I am poor by accident, not by design" - Josh Billings.


  1. "When asked why, 86% of the lower and lower middle income countries listed affordability as the most common reason" These countries cannot afford the 1st and 2nd line DMTs. Basically they're saying that it is more cost effective for the country to allow patients to progress without treatment than to delay disability with treatment. Sad state of affairs in 2014.

  2. Well, you could interpret this two ways low and income countries do not have access to second line DVD's by reading the income data. To study the map of prevalence of MS it would appear that low income countries, mainly African have the lowest rates of MS. And why this so that is a far more interesting question! Is MS a first world disease requiring the greater consumption of MS medications?

  3. When I posted this blog the Ebola crisis was looming and being poor is simply a poor state of affairs. We are fortunate in this country that we have the NHS...


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