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U.S. Prescriber and Payer Perspective on Current Mainstays, Recent Launches, Late-Stage Products, and the First Generic Competitors The array of disease-modifying therapies (DMTs) approved for the treatment of multiple sclerosis (MS) has grown considerably in the last five years with the launches of oral therapies (e.g., dimethyl fumarate [Biogen’s Tecfidera]), alemtuzumab [Genzyme/Sanofi’s Lemtrada]) and of improved follow-ons of key current mainstays (e.g., pegylated IFN-?-1a [Biogen’s Plegridy]). Added to the mix will soon be novel products (e.g., AbbVie/Biogen’s Zinbryta) and next-generation follow-ons (e.g., Celgene/Receptos’s ozanimod) for the already-crowded relapsing MS market and potentially the first drug approved specifically for primary-progressive multiple sclerosis (Roche/Genentech’s ocrelizumab). Meanwhile, generic erosion in the MS market began with the June 2015 launch of generic glatiramer acetate 20 mg/mL (Sandoz/Momenta’s Glatopa), and oral generics are on the horizon. With a continuing influx of costly new DMTs and the onset of generic competition, prescriber choice and payer decisions will become increasingly complex as marketers vie for favorable formulary position and health plans work to contain drug-related healthcare spend in this high-cost market.

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