OBJECTIVES : Multiple sclerosis (MS) is a chronic, progressive neurological disease, which at present cannot be cured. MS rates in Canada are among the highest reported worldwide. Disease-modifying drugs (DMDs) are used to prevent disability and delay disease progression in MS patients. Fourteen DMDs are approved in Canada, of which three (peginterferon beta-1a, ocrelizumab, and cladribine) entered the market since 2015. The objective of this study was to evaluate the Canadian market for DMDs since 2015.

METHODS : Data on retail prescriptions and on drugstore and hospital purchases of DMDs in Canada were obtained from IQVIA. Numbers of prescriptions and purchases (in $Can) were collected for 12-month periods ending February for the past five years (2015-2019).

RESULTS : Total purchases of DMDs in Canada increased by 31%, from $447.8 million in the 12 months ending February 2015 to $585.0 million in the 12 months ending February 2019; during this period prescription activity increased by 16% (from 224,432 to 260,641). Glatiramer acetate, teriflunomide and dimethyl fumarate dominated the market, increasing from 47% of prescription activity combined in 2015 to 60% in 2019. In terms of purchases, in the 12 months ending February 2019 three oral DMDs were market leaders: dimethyl fumarate (17.4%), followed by fingolimod (16.2%), and teriflunomide (15.6%). Market shares of the three newest DMD entrants in Canada accounted for 7.2% of the value of DMD purchases (totalling $42.2 million) in the 12 months ending February 2019 but only 2.1% of prescriptions (totalling 5,507 prescriptions), reflecting the higher prices of these new therapies.

CONCLUSIONS : DMDs represent a market of more than $585 million dollars in Canada. Market growth in terms of purchases compared to prescriptions reflects the strong uptake and higher prices of some of the newer MS therapies.