% of people who can afford each DMT in the country of Interest World Bank category High income WHO region European Global results
Estimated % of people with MS who can afford each DMT
Alemtuzumab 100% 83% 79% 65%
Azathioprine 100% 79% 81% 84%
Cladribine (subcutaneous or IV) 100% 47% 47% 40%
Cladribine (oral) 100% 92% 90% 70%
Cyclophosphamide 100% 80% 80% 77%
Dimethyl fumarate 100% 95% 96% 90%
Diroximel fumarate 100% 66% 68% 46%
Fingolimod 100% 93% 89% 86%
Fludarabine N/A - This DMT not available in the country or unable to be prescribed for MS 20% 18% 14%
Glatiramer acetate 100% 94% 96% 83%
Interferon-beta 1a 100% 94% 95% 86%
Interferon-beta 1b 100% 94% 96% 85%
IV Immunoglobulin (IVIG) 100% 70% 69% 62%
Leflunomide N/A - This DMT not available in the country or unable to be prescribed for MS 14% 5% 14%
Methotrexate 100% 79% 77% 70%
Minocycline N/A - This DMT not available in the country or unable to be prescribed for MS 14% 5% 11%
Mitoxantrone 100% 84% 83% 73%
Monomethyl fumarate N/A - This DMT not available in the country or unable to be prescribed for MS 1% 1% 1%
Mycophenolate mofetil N/A - This DMT not available in the country or unable to be prescribed for MS 18% 10% 31%
Natalizumab 100% 94% 90% 77%
Ocrelizumab 100% 91% 89% 76%
Ofatumumab 100% 85% 79% 60%
Ozanimod 100% 64% 66% 45%
Peginterferon-beta 1a 100% 91% 93% 70%
Ponesimod 100% 60% 64% 42%
Rituximab 100% 89% 88% 81%
Siponimod 100% 81% 75% 57%
Teriflunomide 100% 92% 94% 88%

Please note only 61 countries were able to provide estimates for this question and the data is highly variable within World Bank categories and WHO regions, with many outliers.

What is the Atlas of MS?

The Atlas of MS is the most comprehensive worldwide study of the epidemiology of MS and the global availability and accessibility of resources for people with MS.

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The Atlas of MS is one of the strongest examples of what the global MS movement can achieve through collaboration. By bringing together evidence from countries around the world, it helps inform policy, strengthen advocacy and guide future investment in research and healthcare. The Atlas also highlights the need for continued investment in surveillance, registries and data systems to strengthen our understanding of the true burden of MS. Better data lead to better decisions and, ultimately, better outcomes for people affected by MS worldwide.

Professor Mario Alberto Battaglia
Chair, MS International Federation (MSIF) and President of the Italian MS Society (Associazione Italiana Sclerosi Multipla [AISM])