% 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 2% 83% 79% 65%
Azathioprine N/A - This DMT not available in the country or unable to be prescribed for MS 79% 81% 84%
Cladribine (subcutaneous or IV) N/A - This DMT not available in the country or unable to be prescribed for MS 47% 47% 40%
Cladribine (oral) 5% 92% 90% 70%
Cyclophosphamide N/A - This DMT not available in the country or unable to be prescribed for MS 80% 80% 77%
Dimethyl fumarate 45% 95% 96% 90%
Diroximel fumarate N/A - This DMT not available in the country or unable to be prescribed for MS 66% 68% 46%
Fingolimod 5% 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 15% 94% 96% 83%
Interferon-beta 1a 6% 94% 95% 86%
Interferon-beta 1b 15% 94% 96% 85%
IV Immunoglobulin (IVIG) 0% 70% 69% 62%
Leflunomide N/A - This DMT not available in the country or unable to be prescribed for MS 14% 5% 14%
Methotrexate 0% 79% 77% 70%
Minocycline N/A - This DMT not available in the country or unable to be prescribed for MS 14% 5% 11%
Mitoxantrone 0% 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 0% 18% 10% 31%
Natalizumab 5% 94% 90% 77%
Ocrelizumab 4% 91% 89% 76%
Ofatumumab N/A - This DMT not available in the country or unable to be prescribed for MS 85% 79% 60%
Ozanimod N/A - This DMT not available in the country or unable to be prescribed for MS 64% 66% 45%
Peginterferon-beta 1a 2% 91% 93% 70%
Ponesimod N/A - This DMT not available in the country or unable to be prescribed for MS 60% 64% 42%
Rituximab 0% 89% 88% 81%
Siponimod 0% 81% 75% 57%
Teriflunomide 10% 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.

2020-22 worldwide study

The data shows that the number of people with MS across the globe has increased from 2.3 million in 2013 to 2.8 million in 2020 and 2.9 in 2023. It highlights the many barriers and inequalities that people with MS face in accessing diagnosis, treatment and care. Download the reports to see the full findings and recommendations or download the full dataset if you would like to conduct your own analysis comparing multiple countries.

Powerful tool for change

The information in the Atlas of MS can be a powerful advocacy tool, shining a spotlight on MS and raising awareness of the lack of adequate resources available to diagnose, inform, treat, rehabilitate and support people with MS worldwide.

With thanks to…

Worldwide collaboration

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.

See contributor list

This 3rd edition of the Atlas of MS shines a spotlight on the barriers to accessing diagnosis and disease modifying therapies around the world. These issues are particularly evident in low and middle income countries but high income countries are not exempt. This report highlights the need for major policy changes to ensure early diagnosis and improved access to a range of treatments, to guarantee the best possible outcomes for people with MS. Information from the Atlas of MS should be used to guide policy-makers, health planners and specialists, in order to close the gaps in care, decrease inequities globally and provide a better future for people with MS and their families.

Professor Mai Sharawy
Professor of Neuro-Ophthalmology at Cairo University – Egypt.
Founder of MS Care and Chair of MSIF Board