Practices of US health insurance companies concerning MS therapies interfere with shared decision-making and harm patients
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Updated: Mar 22, 2026

Determining Immune System Suppression versus CNS Protection for Pharmacological Interventions in Autoimmune Demyelination
Published on: September 12, 2016
Dennis N Bourdette1, Daniel M Hartung1, Ruth H Whitham1
1Department of Neurology (DNB, RHW), Oregon Health & Science University, Portland; Multiple Sclerosis Center of Excellence West (DNB, RHW), VA Portland Health Care System, OR; and The College of Pharmacy (DMH), Oregon State University/Oregon Health & Science University, Portland.
Abstract:
The US Food and Drug Administration has registered 13 multiple sclerosis (MS) disease-modifying therapies (DMTs). The medications are not interchangeable as they vary in route of administration, efficacy, and safety profile. Selecting the appropriate MS DMT for individual patients requires shared decision-making between patients and neurologists. To reduce costs, insurance companies acting through pharmacy benefit companies restrict access to MS DMTs through tiered coverage and other regulations. We discuss how policies established by insurance companies that limit access to MS DMTs interfere with the process of shared decision-making and harm patients. We present potential actions that neurologists can take to change how insurance companies manage MS DMTs.
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