1. Background The management of MS is becoming increasingly complex with new DMTs reducing frequency and severity of relapses and accumulation of lesions[1]. Newly introduced oral therapies include dimethyl fumarate and fingolimod. Rituximab, has been used recently to treat MS, although off label[2]. Regardless of the increase in options, cost of MS DMTs has increased dramatically. Objectives To investigate pricing trajectories of MS DMTs, specifically glatiramer acetate(GA), rituximab(RTX), natalizumab(NTZ), fingolimod(FTY), and dimethyl fumarate (DMF) between 2010-2015. To compare Anticipated vs. Market price of MS DMTs between 2010-2015, following the introduction of first oral DMT, FTY. Methods Data source: Market Price obtained from REDBOOK® for every year following approval of DMT. Assumption: Baseline Market and Anticipated Price is set at earliest 2010 Market Price for the DMT. Focus of analysis is comparing Market vs. Anticipated Price/Rate from baseline. Market Price: Average Wholesale Price (AWP) as conservative estimate with 15% discount rate. Anticipated Price: Expected Price based on Consumer Price Index (CPI) for Prescription Drugs with inflation adjusted is calculated using below equation: where r is the monthly CPI inflation rate for prescription drugs. Results Rate of costs for MS DMTs is substantially greater than the CPI rates of inflation for prescription drugs. There is a critical need to address these dramatically increasing MS DMT prices. Prescribers should be aware of the high price of MS DMTs, particularly the newly developed ones, and assess the cost-effectiveness of MS DMTs to provide patients with the most cost-effective option. Comparing the increase in cost of drug prices among Multiple Sclerosis drugs: Anticipated vs. Market Prices between 2010-2015 Comparing the increase in cost of drug prices among Multiple Sclerosis drugs: Anticipated vs. Market Prices between 2010-2015 Kim C.H. 1, Brandi Vollmer 2,3, Jon Campbell 1, John Corboy MD 2, Timothy Vollmer MD 2, Kavita V. Nair 1 1 Department of Clinical Pharmacy (DOCP), University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences 2 Rocky Mountain MS Center at CU, University of Colorado Department of Neurology 3 Colorado School of Public Health, University of Colorado Anschutz Medical Campus Key lesson: Prices of MS DMTs have increased drastically (at least 5% per year) with Market price increasing at a rate of at least 1.67 to 4.81 times compared to Anticipated price of MS DMTs. Conclusions References 1. Hart FM, Bainbridge J: Current and emerging treatment of multiple sclerosis. Am J Manag Care 2016, 22(6 Suppl):s159-170. 2. Rommer PS, Dorner T, Freivogel K, Haas J, Kieseier BC, Kumpfel T, Paul F, Proft F, Schulze- Koops H, Schmidt E et al: Safety and Clinical Outcomes of Rituximab Treatment in Patients with Multiple Sclerosis and Neuromyelitis Optica: Experience from a National Online Registry (GRAID). J Neuroimmune Pharmacol 2016, 11(1):1-8. Average Price Rate of Change per year for GA was 17.13% and 3.56% based on the Market and CPI inflation rate, respectively. The rate ratio indicated 4.81 times greater change in market price for GA compared to CPI inflation rate. Average Price Rate of Change per year for Rituximab was 6.68% and 4.01%, which was the lowest of all DMTs compared from 2010-2015. Only 1.67 times greater change in Market price for Rituximab compared to CPI inflation rate. DMF had the highest market price increase per year with $6,614 while Rituximab showed the smallest increase of $1,510 from 2010 to 2015. * Market and Anticipated Rate differs based on different starting/ending price date.