Reducing the Out-of-Pocket Costs of Disease-Modifying Therapies for Medicare Beneficiaries With Multiple Sclerosis

Annual OOP costs for self-administered DMTs among Medicare beneficiaries with MS decreased significantly beginning January 1, 2025, because of the IRA's annual OOP maximum. Beneficiaries who voluntarily enroll in the MPPP will also be able to spread OOP costs over more manageable monthly payments. Direct cash purchase of some generic DMTs through DTC pharmacies could lead to lower OOP costs, but these payments will not count toward beneficiaries' deductible or annual OOP maximum. Neurologists have a critical role in ensuring that their Medicare patients with MS are aware of the option to enroll in the MPPP and the possibility of obtaining generic DMTs through DTC pharmacies.