Cost Challenges in Treating MS: A Look at Infusion Therapy

Multiple sclerosis (MS) affects nearly 1 million people in the U.S., and for many, treatment costs are a significant burden. March is National MS Education and Awareness Month, a time to shine a light on the challenges faced by MS patients, including the high cost of disease-modifying therapies (DMTs) like Ocrevus and Tysabri.

For employers and health plans, MS is a high-cost condition that requires careful management. A study funded by the National MS Society found that the average annual cost of living with MS is $88,487 per person, with expenses divided into:

• Direct medical costs: ~$65,612 per patient annually, including hospital visits, outpatient care, and DMTs.
• DMTs alone account for 54% of these direct costs, ranging from $57,202 to $92,719 per year.
• Indirect and non-medical costs: $22,875 per patient annually, driven by lost productivity, absenteeism, and caregiving needs.

While advances in treatment have improved quality of life for MS patients, the cost of infusion therapy remains a major financial challenge that can significantly impact both patients and employer-sponsored health plans.

The Cost of MS Infusion Therapy: A Major Expense for Employers

One of the most commonly prescribed MS infusion therapies is Ocrevus (ocrelizumab), which carries a staggering price tag:

• List price: $78,858 per year

• Total healthcare costs for Ocrevus patients:

• First year: $125,597
• Second year: $109,618
• Cost drivers: The drug itself accounts for over 78% of total treatment costs.

For comparison, the average annual cost of all MS DMTs ranges from $57,202 to $92,719, making MS one of the most expensive chronic conditions to manage.

Why Site of Service Matters

For many MS patients, where they receive infusion therapy determines the true cost of treatment.

• Hospital outpatient infusions can see markups as high as 500%.
• Ambulatory infusion centers (AICs) often mark up drug costs by 50%.
• Home infusions eliminate these markups, providing major cost savings.

For employers, redirecting infusion therapy away from high-cost hospital settings can significantly reduce healthcare spending while maintaining the quality of care.

The Workplace Impact of MS

Beyond the direct costs of treatment, MS also affects workforce productivity:

• MS patients average 29.8 disability days per year—more than six times the national average.
• Employees with relapsing-remitting MS (RRMS) experience absenteeism levels twice as high as non-MS employees.
• Presenteeism (working while unwell) is 1.8 times higher, reducing overall productivity.

These workplace challenges reinforce the need for cost-effective, patient-friendly infusion therapy options—like those provided by Leap Health.

Employers Can Make a Difference This MS Awareness Month

This National MS Education and Awareness Month, it's time to rethink how MS care is delivered. The high cost of infusion therapy is a major challenge, but solutions exist. By choosing smarter, more cost-effective infusion options, employers can reduce costs while improving care for their employees.