Multiple Sclerosis Society of Canada

Disease-modifying therapies

These are a class of drugs that impact the underlying disease. DMTs target some aspect of the inflammatory process of MS and appear to reduce the frequency and severity of relapses; reduce the number of new lesions in the brain and spinal cord as seen on MRI; and slow down the accumulation of disability.

Because of the way these medications work, they are used for treatment in individuals with relapsing-remitting MS and secondary progressive MS, with relapses. Unfortunately, no disease-modifying therapy has yet been approved to treat primary progressive MS — the type of MS that shows steady progression at onset.

These medications, which are generally taken on a long-term basis, are the best defense currently available to slow the natural course of MS. Decisions about taking a disease-modifying therapy are best made by carefully considering and weighing factors including individual lifestyle, disease course, known side-effects, and the potential risks and benefits of the different therapies.

Making Treatment & Lifestyle Decisions: Thinking About Benefits & Risks

Switching therapies

People with MS should discuss their disease management plans with their neurologist, keeping in mind their disease history and treatment goals, to determine whether changing therapies are a suitable option for them. Due to the large number of different MS therapies currently available, as well as the fact that each therapy may have a different mechanism of action, people with MS should discuss their disease management plans with their physician.

Brand
(Generic Name)
Health Canada Indication Administration and dose

Aubagio®
(teriflunomide)
Genzyme, a Sanofi company

Drug Support Program:
MS One to One™
1-855-MS1-2ONE
(1-855-671-2663)

Relapsing remitting MS

One 14mg tablet taken orally daily


Click here for a list of common side effects.

Avonex®
(interferon beta-1a)
Biogen Canada

Drug Support Program:
Biogen ONETM
1-855-MSONE-00
(1-855-676-6300)

Relapsing-remitting MS
Secondary-progressive MS with relapses
Clinically isolated syndrome (CIS)

One 30mcg injection into the muscle once a week


Click here for a list of common side effects.

Betaseron®
(interferon beta-1b)
Bayer HealthCare Pharmaceuticals Inc.

Drug Support Program:
MS Pathways
1-800 977-2770

Relapsing-remitting MS
Secondary-progressive MS with relapses
CIS

One 250 mcg injection under the skin every other day

Click here for a list of common side effects.

Copaxone®
(glatiramer acetate)
Teva Neuroscience Canada

Drug Support Program:
Shared Solutions
1-800-283-0034
mswatch.ca

Relapsing-remitting MS
CIS

One 20 mg injection under the skin daily


Click here for a list of common side effects.

Extavia®
(interferon beta-1b)
Novartis Pharmaceuticals Canada Inc.

Drug Support Program:
Extracare
1-888-557-5050
extaviaextracare.ca

Relapsing-remitting MS
Secondary-progressive MS (with relapses)
CIS

One 250 mcg injection under the skin every other day


Click here for a list of common side effects.

Gilenya
(fingolimod)
Novartis Pharmaceuticals Canada Inc.

Drug Support Program:
Gilenya® Go Program
1-855-PILL-4MS
(1-855-745-5467)
gilenya.ca

Relapsing-remitting MS.
Recommended for people who have not responded adequately to other disease-modifying therapies or who are unable to tolerate them.

One 0.5mg capsule taken orally daily


Click here for a list of common side effects.

Lemtrada
(alemtuzumab)
Genzyme, a Sanofi company

Drug Support Program:
MS One to One™
1-855-MS1-2ONE
(1-855-671-2663)

Relapsing-remitting MS, with active disease in people who have had an inadequate response to other disease-modifying therapies.

One 0.5mg IV infusion daily for five consecutive days in year 1 of treatment, and one 0.5mg IV infusion for three consecutive days in year 2.


Click here for a list of common side effects.

Plegridy
(peginterferon beta-1a)

Drug Support Program:

Biogen ONE™
1-855-MSONE-00
(1-855-676-6300)

Relapsing-remitting MS One 125mcg injection under the skin once every two weeks


Click here for a list of common side effects.

Rebif®
(interferon beta-1a)
EMD Serono Canada Inc.

Drug Support Program:
Multiple Support Program 1-888-677-3243

Relapsing-remitting MS
Secondary-progressive MS with relapses
CIS

One 44 mcg injection under the skin three times per week.
or
One dose of 22 mcg injected under the skin three times per week.
Also available in a pre-filled syringe.


Click here for a list of common side effects.

Tecfidera
(Dimethyl fumarate)
Biogen Canada

Drug Support Program:
Biogen ONETM
1-855-MSONE-00
(1-855-676-6300)

Relapsing-remitting MS

Two 120mg capsules taken orally, twice daily or one 240mg capsule taken orally, twice daily


Click here for a list of common side effects.

Tysabri®(natalizumab)
Biogen Canada

Drug Support Program:
Biogen ONETM
1-855-MSONE-00
(1-855-676-6300)

Relapsing-remitting MS.
Recommended for people who have not responded adequately to other disease-modifying therapies or who are unable to tolerate them.

One 300mg IV infusion every four weeks


Click here for a list of common side effects.

Legend:

RRMS – relapsing remitting multiple sclerosis
CIS – clinically isolated syndrome
MRI – magnetic resonance imaging

Drug costs and reimbursement

The base cost of disease-modifying therapies for MS varies widely and typically falls in the range of $20,000 to $40,000 per year. The total cost of the medication will depend on the treatment selected, the dosage, provincial drug program pricing, pharmacy or clinic costs and dispensing fees.

The level of drug reimbursement and access criteria varies from province to province and the MS Society is working to ensure that people who could benefit from treatment have access.

The Common Drug Review (CDR) at the Canadian Agency for Drugs and Technologies in Health (CADTH) is a pan-Canadian process for conducting objective, rigorous reviews of the clinical, cost-effectiveness, and patient evidence for drugs. Depending on the province, this can take anywhere from 8-24 months from initial submission to final recommendation. It should be noted that Quebec conducts its own review, independent of the CDR.

For more information about these therapies or for other information about MS management, please contact your physician, or the Multiple Sclerosis Society of Canada at 1-800-268-7582.