title: Disease-modifying drugs in multiple sclerosis: a review of expenditure in Ireland.
abstract: BACKGROUND
  The prevalence of multiple sclerosis (MS) in Ireland is well over the European and global averages and the costs associated with managing this disease are placing a heavy economic burden on the Irish healthcare system. This paper investigates how current therapies used to treat MS are impacting on the total cost of MS as well as the potential impact of oral therapies in the MS marketplace.
  
  
  METHODS
  Sales and expenditure data on MS disease-modifying drugs were reviewed as were market reports on forthcoming therapies in the MS pipeline. Clinical trial results for both current and prospective compounds were also reviewed to analyse how safety and efficacy data are influencing drug availability and expenditure.
  
  
  RESULTS
  The high cost of disease-modifying drugs is substantially increasing the total cost of MS in Ireland. Newer therapies are likely to contribute to this trend. Safety concerns continue to be a barrier to advancement of the most promising compounds in the MS pipeline.
  
  
  CONCLUSIONS
  Structures and/or treatment algorithms may be needed to help manage the growing cost of treating MS in Ireland to ensure all patients have access to safe, efficacious treatments.
authors.affiliation: School of Medicine, Trinity College Dublin, College Green, Dublin 2, Ireland. bbailey@tcd.ie
authors.forename: B
authors.initials: B
authors.lastname: Bailey
mesh_terms: D000276:Adjuvants, Immunologic / Q000191:economics / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000191:economics / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000068717:Glatiramer Acetate; D017048:Health Care Costs; D006801:Humans; D000068556:Interferon beta-1a; D000068576:Interferon beta-1b; D016899:Interferon-beta / Q000191:economics / Q000627:therapeutic use; D007494:Ireland; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000191:economics*; D000069442:Natalizumab; D010455:Peptides / Q000191:economics / Q000627:therapeutic use
chemical_list: D000276:Adjuvants, Immunologic; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000069442:Natalizumab; D010455:Peptides; D000068576:Interferon beta-1b; D000068717:Glatiramer Acetate; D016899:Interferon-beta; D000068556:Interferon beta-1a