Managed care aspects of managing multiple sclerosis.

Multiple sclerosis (MS) is associated with significant direct and indirect costs. Pharmacoeconomic studies of MS therapies have generally shown results which were not considered to be cost-effective when incremental cost-effectiveness ratios were analyzed for quality-adjusted life-years. When prevented relapses were considered as an end point, the cost-effectiveness results were generally more favorable, although the studies analyzed were limited by assumptions, projected outcomes, and lack of data on adverse events. Managed care professionals and clinicians can ensure maximized effectiveness of therapy by supporting adherence and by providing disease therapy management programs. Specialty pharmacies are an effective way to control costs and optimize the involvement of patients in their care.