Recent years have seen rapid developments in diagnostic criteria, treatment options and monitoring procedures in multiple sclerosis (MS), as well as an improved overall understanding of the disease. Major policy changes are needed, however, to translate these advances into better outcomes for people with MS and those who care for them.

Our vision is that the following recommendations will be used widely among those committed to creating a better future for people with MS and those who care for them. To download a summary of the MS Brain Health recommendations click here.

1. Minimize delays in diagnosis of MS and in the time to treatment initiation.
  • Educate the general public to take prompt action if early symptoms of MS develop, by visiting a healthcare professional. Awareness campaigns that highlight the typical initial symptoms, the negative impact of delaying treatment and the personal and societal costs of the disease would support this.

National bodies
Patient groups

  • Educate family and primary care physicians about the importance of promptly referring people with suspected MS to a neurologist, and ultimately to a specialist clinic, to speed up diagnosis and treatment initiation.

National bodies
Professional bodies
Healthcare providers

  • Recommend that general neurologists refer people suspected of having the disease to specialist MS neurologists.

National bodies
Professional bodies
Healthcare providers

  • Improve access to specialist care for MS: make diagnostic and monitoring procedures more widely accessible, increase the numbers of healthcare professionals who specialize in the management of MS, and ensure that these specialists provide prompt diagnostic and support services for people with suspected MS and those who have been newly diagnosed with the disease.

National bodies
Healthcare providers
Reimbursement agencies

  • Adopt the latest accepted diagnostic criteria, in order to diagnose MS as early as possible.

National and international bodies
Healthcare providers

  • Align prescribing guidelines with the latest accepted diagnostic criteria to give people with MS the opportunity to start treatment and receive support promptly, as soon as diagnosis is confirmed.

National bodies
Healthcare providers

2. Set goals for treatment and ongoing management that will optimize outcomes for every person with MS.
  • Ensure that MS healthcare professionals can take the time to educate people with MS about strategies to manage their disease. Emphasize the importance of a ‘brain-healthy’ lifestyle, the benefits of early treatment with therapies that can modify the disease course, the likely consequences of inadequate or suboptimal treatment and the goal of minimizing disease activity while optimizing safety.

National bodies
Professional bodies
Healthcare providers

  • Implement a shared decision-making process that embodies dialogue between people with MS and healthcare professionals. A well-informed and proactive collaboration between people with MS and their healthcare team is vital to successful management of the disease.

National bodies
Professional bodies
Healthcare providers

  • Make the full range of disease-modifying therapies available to people with active relapsing forms of MS, regardless of their treatment history, to speed up adoption of the most appropriate treatment strategy that optimizes effectiveness and safety for each individual.

Regulatory authorities
Healthcare providers
Health technology assessors
Reimbursement agencies

  • Include evidence from monitoring via regular clinical evaluation and scheduled/unscheduled MRI brain scans in any definitions of disease activity or suboptimal response, in order to assist in the rapid identification of treatment failure and the decision to switch treatment.

Healthcare providers
Regulatory authorities

  • Ensure that MS healthcare professionals can take the time to monitor disease activity in people with MS.

National bodies
Healthcare providers

  • Agree and implement standardized data collection techniques, protocols and data sets, nationally and internationally, to track clinical and subclinical events in routine practice. Incorporate these into a clinical management tool to facilitate individualized practice.

National and international bodies
Healthcare providers
Curators of registries and databases

  • Maintain treatment with a disease-modifying therapy for as long as a person with MS would be at risk of inflammatory disease activity if they were not receiving treatment; in the case of a suboptimal response, make a prompt decision about whether or not to switch therapy.

Healthcare providers
Reimbursement agencies

  • Seek regulatory and health technology assessment approvals to implement these recommendations.

Pharmaceutical companies
Professional bodies
Patient groups
Any other stakeholders

3. Consult the most robust evidence base possible when making treatment and management decisions.
  • Carry out economic evaluations of therapies and other healthcare interventions from a societal perspective, considering the health benefits and costs to all parties, to improve assessments of true cost-effectiveness.

Health technology assessors
Reimbursement agencies
Patient groups

  • Encourage the continuing investigation, development and use of cost-effective therapeutic strategies, of approaches that reduce the costs of managing MS and of alternative financing models, to improve access to treatment.

Regulatory authorities
Healthcare providers
Health technology assessors
Reimbursement agencies

  • Agree and implement standardized data collection techniques, protocols and data sets, nationally and internationally, to track clinical and subclinical events in routine practice. Incorporate these into national and international MS registries and databases to generate real-world evidence of the long-term effectiveness and safety of therapeutic strategies; such evidence can be used by regulatory bodies and payers, and will enable differences in practice patterns to be assessed and addressed.

National and international bodies
Healthcare providers
Curators of registries and databases

  • Improve access to specialist care for MS: make diagnostic and monitoring procedures more widely accessible, increase the numbers of healthcare professionals who specialize in the management of MS, and ensure that these specialists provide prompt diagnostic and support services for people with suspected MS and those who have been newly diagnosed with the disease.

National bodies
Healthcare providers
Reimbursement agencies

  • Ensure that access to multiple sclerosis registries and databases is available for those carrying out health technology assessments and economic evaluations.

National and international bodies
Healthcare providers
Curators of registries and databases