Download the executive brief

Multiple Sclerosis facts

Multiple Sclerosis (MS) is a lifelong disease that directly impacts the central nervous system1.

Over 1 million Americans have been diagnosed with MS, which includes a wide range of symptoms from depression, fatigue and weakness to pain, itching, vision problems, difficulty walking and trouble with memory and concentration.2.

The costs of disease-modifying drugs for MS patients have more than tripled over the last ten years3.

What is the Multiple Sclerosis Care Value Program?

Through the Multiple Sclerosis Care Value ProgramSM, part of the SafeGuardRx® platform, we combine specialized clinical care and unique cost containment strategies to drive adherence and cost savings.

Most importantly, the program helps MS patients gain access and maintain adherence to innovative therapies that can reduce relapses and slow the progression of the disease.

Member Benefits

1:1 care consultation

Access to first-in-class care through the Neurology and Multiple Sclerosis Therapeutic Resource Center® where members receive one-on-one consultation from specialist clinicians (who are available 24/7), clinical assessments and proprietary depression screening.

Digital engagement

Patient-friendly digital tools, including Interactive Voice Response, text refill reminders and online support from the MS community.

Plan Benefits

Greater adherence

As the program drives adherence, overall plan costs reduce due to fewer hospital stays and disease relapses.

Financial protection

Early discontinuation reimbursement for plans if members discontinue their medications within their first three fills.*

Utilization management

Access to the right medication through National Preferred Formulary and utilization management tools.

Frequently Asked Questions

  • How will new drugs such as generics or biosimilars roll into the program?

    Evernorth® will review each new drug upon approval for its inclusion in the Multiple Sclerosis Care Value Program. At this time, it is unclear of when generics or biosimilars within this therapy class will be approved. However, the new Multiple Sclerosis Care Value Program lays the foundation to manage new drugs as appropriate.

  • How does the program affect advanced utilization management (AUM) offerings?

    The Multiple Sclerosis Care Value Program does not interfere with or replace any of our advanced utilization management offerings (AUM), such as prior authorization (PA) or preferred specialty management (PSM). AUM packages, including PA or PSM for multiple sclerosis drugs, will continue to provide value by managing the drugs in the class to provide a holistic approach to cost management.

* Early discontinuation reimbursement will be provided if members discontinue after first fill for Mavenclad due to its unique dosing.

  1. National Multiple Sclerosis Society.
  2. National Multiple Sclerosis Society. How Many People Live With MS?
  3. National Multiple Sclerosis Society. Affordability of and Access to MS Medications.