% of people who can afford each DMT in the country of Interest World Bank category Lower middle income WHO region Eastern Mediterranean Global results
Estimated % of people with MS who can afford each DMT
Alemtuzumab 1% 13% 29% 65%
Azathioprine 100% 98% 96% 84%
Cladribine (subcutaneous or IV) 10% 34% 68% 40%
Cladribine (oral) 10% 19% 39% 70%
Cyclophosphamide 50% 83% 93% 77%
Dimethyl fumarate N/A - This DMT not available in the country or unable to be prescribed for MS 76% 90% 90%
Diroximel fumarate N/A - This DMT not available in the country or unable to be prescribed for MS 0% 3% 46%
Fingolimod 1% 77% 93% 86%
Fludarabine N/A - This DMT not available in the country or unable to be prescribed for MS 0% 3% 14%
Glatiramer acetate N/A - This DMT not available in the country or unable to be prescribed for MS 44% 54% 83%
Interferon-beta 1a 5% 57% 93% 86%
Interferon-beta 1b 5% 53% 93% 85%
IV Immunoglobulin (IVIG) 1% 37% 64% 62%
Leflunomide 30% 19% 39% 14%
Methotrexate 100% 54% 96% 70%
Minocycline 100% 4% 8% 11%
Mitoxantrone 30% 49% 90% 73%
Monomethyl fumarate N/A - This DMT not available in the country or unable to be prescribed for MS 0% 3% 1%
Mycophenolate mofetil 20% 81% 90% 31%
Natalizumab 1% 28% 56% 77%
Ocrelizumab 5% 44% 90% 76%
Ofatumumab N/A - This DMT not available in the country or unable to be prescribed for MS 0% 3% 60%
Ozanimod N/A - This DMT not available in the country or unable to be prescribed for MS 0% 3% 45%
Peginterferon-beta 1a N/A - This DMT not available in the country or unable to be prescribed for MS 5% 4% 70%
Ponesimod N/A - This DMT not available in the country or unable to be prescribed for MS 0% 3% 42%
Rituximab 10% 72% 94% 81%
Siponimod N/A - This DMT not available in the country or unable to be prescribed for MS 0% 3% 57%
Teriflunomide 5% 76% 91% 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 relies on data supplied by MS organisations from around the world. We are most grateful to the country coordinators and their colleagues for taking the time and effort to gather the information and data.

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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])