Evolving Health Policies and Pricing Dynamics in U.S. Multiple Sclerosis Therapies: A Longitudinal Analysis with Policy Implications

Background and Objectives: Multiple sclerosis (MS) is a chronic autoimmune neuroinflammatory condition associated with significant disability. Given the increasing number of patients with MS, the growing number of available disease-modifying therapies (DMTs), and the substantial economic burden associated with MS, it is critically important to determine which treatment options are the most cost-effective. The economic burden of MS is considerable, and high-cost DMTs, whose prices continue to rise, represent the primary driver of health expenditures related to MS. The primary aim of this narrative review is to provide a brief review of the economic issues related to MS DMTs, including pricing trends, economic burden, and their impact on patient care, and to propose potential policy solutions. Materials and Methods: The aim of the study was to compare the cost effectiveness of The annual costs of DMTs from 1993 to 2023 in USA. An examination of DMT pricing trends suggests that pricing has been influenced in part by within-class competition and the availability of generic DMT options. Results: Over the past decade, the prices of DMTs have increased by more than 50%. Currently, the annual cost of many DMTs used in the treatment of MS has exceeded $100,000, and their economic value is widely debated. The high cost of DMTs and difficulties in timely access to medications can lead to psychological stress among many patients. Studies on cost-effectiveness indicate that the clinical benefits provided by DMTs do not fully justify their high costs, which further exacerbates issues related to economic accessibility. Conclusions: Collaborative neuropsychiatric care models, in which neurologists and mental health professionals work in coordination, may improve symptom recognition, optimize adherence to DMTs, and enhance overall functioning. Given that treatment non-adherence and reduced quality of life negatively affect cost-effectiveness outcomes, early psychiatric intervention may indirectly improve the economic value profile of high-cost DMTs.