2026 Accomplishments: CNMSC Drug Access Working Group Project

Background

In 2022, the Canadian Network of Multiple Sclerosis (MS) Clinics (CNMSC) launched an initiative aimed at improving access to MS medications for people living with MS (PLWMS) at both national as well as provincial levels. MS Canada is a key partner in this initiative, helping to ensure that the voice of PLWMS is a consistent part of the dialogue with decision makers.

The project is sponsored through unrestricted grants from: Amgen Canada Inc., Biogen Canada Inc., EMD Serono Inc., Novartis Pharmaceuticals Inc., and Hoffman-LaRoche Limited. This funding provides support for the research, analysis, engagement, and project management requirements to ensure the success of this initiative.

What are the goals of the project?

The goals of the project are:

To provide timely MS clinician expert input and/or feedback to health technology assessment (HTA) bodies (i.e., CDA1 and/or INESSS2) regarding disease modifying therapy (DMT) approvals/use for PLWMS and related demyelinating disorders;
To advocate for alignment of provincial criteria re: DMT access; and
To improve access for children living with MS to DMTs across Canada.

What has been accomplished to date?

The work of this project has moved forward under three pillars, and the accomplishments associated with each thus far (i.e., to July 2026) are outlined below.

Pillar	Areas of Focus	Activities/Accomplishments
HTA-focused activities	Engagement of CDA on a range of HTA and policy issues Input to CDA reviews and/or reports	Meeting with CDA regarding the impact of the 2024 McDonald criteria (December 2025 + on-going). CNMSC and MS Canada letter to CDA requesting engagement of provinces to improve pediatric access for MS DMTs (Dec 2025 + on-going). Input on CDA consultations Input to consultations regarding process changes (Feb 2026), resulting in CDA putting aside their proposal to eliminate clinician feedback on draft HTA recommendations. Clinician input to Ocrevus subcutaneous HTA review (June 2026). On-going input to CDA’s consultations regarding Evolving Clinician Group Input Submissions Into the Drug Reimbursement Review Process (June 2026). Plans for input to anticipated ocrelizumab pediatric HTA submission (TBD – Fall 2026).
Provincial engagement activities	Leverage learnings from Ontario MS initiative to modernize access criteria and improve access processes for MS medications in other provinces	Tracking of implementation of RIS recommendations at provincial level On-going CNMSC and MS Canada engagement with provinces to accelerate the implementation of 1L cladribine access. Engagement with provinces to secure case-by-case funding for 1L natalizumab, given failed negotiations at pCPA (July 2026). On-going: Collaboration with MS Canada Quebec team re: raising awareness re: 2024 McDonald criteria; monitoring of provincial MS medication access levels and funding criteria, which is leveraged to identify opportunities to improve patient access and to support requests to individual provinces for specific policy changes.
Pediatric access activities	Research and publications regarding pediatric DMT access and/or challenges. HTA and public payer engagement strategy to improve pediatric DMT access.	Engagement of CDA and provinces to address pediatric MS medication access challenges, with the goal of driving policy change to improve provincial Ped MS DMT access (December 2025 + on-going). Funding of Canadian Pediatric Neuroinflammatory Disorders Registry (A. Yeh, et al) under the CDA Rare Disease Registry Funding Opportunity (November 2025). Canadian Pediatric Neuroinflammatory Disorders Registry consultations, in collaboration with MS Canada (March 2026), to secure input from patients/industry/former payers to inform the ongoing development and prioritization of registry activities, in alignment with project objectives, funding requirements, and governance oversight.

Pillar

Areas of Focus

Activities/Accomplishments

HTA-focused
activities

Engagement of CDA on a range of HTA and policy issues
Input to CDA reviews and/or reports

Meeting with CDA regarding the impact of the 2024 McDonald criteria (December 2025 + on-going).
CNMSC and MS Canada letter to CDA requesting engagement of provinces to improve pediatric access for MS DMTs (Dec 2025 + on-going).
Input on CDA consultations
- Input to consultations regarding process changes (Feb 2026), resulting in CDA putting aside their proposal to eliminate clinician feedback on draft HTA recommendations.
- Clinician input to Ocrevus subcutaneous HTA review (June 2026).
- On-going input to CDA’s consultations regarding Evolving Clinician Group Input Submissions Into the Drug Reimbursement Review Process (June 2026).
- Plans for input to anticipated ocrelizumab pediatric HTA submission (TBD – Fall 2026).

Provincial
engagement
activities

Leverage learnings from Ontario MS initiative to modernize access criteria and improve access processes for MS medications in other provinces

Tracking of implementation of RIS recommendations at provincial level
On-going CNMSC and MS Canada engagement with provinces to accelerate the implementation of 1L cladribine access.
Engagement with provinces to secure case-by-case funding for 1L natalizumab, given failed negotiations at pCPA (July 2026).
On-going: Collaboration with MS Canada Quebec team re: raising awareness re: 2024 McDonald criteria; monitoring of provincial MS medication access levels and funding criteria, which is leveraged to identify opportunities to improve patient access and to support requests to individual provinces for specific policy changes.

Pediatric access
activities

Research and publications regarding pediatric DMT access and/or challenges.
HTA and public payer engagement strategy to improve pediatric DMT access.

Engagement of CDA and provinces to address pediatric MS medication access challenges, with the goal of driving policy change to improve provincial Ped MS DMT access (December 2025 + on-going).
Funding of Canadian Pediatric Neuroinflammatory Disorders Registry (A. Yeh, et al) under the CDA Rare Disease Registry Funding Opportunity (November 2025).
Canadian Pediatric Neuroinflammatory Disorders Registry consultations, in collaboration with MS Canada (March 2026), to secure input from patients/industry/former payers to inform the ongoing development and prioritization of registry activities, in alignment with project objectives, funding requirements, and governance oversight.

Policy impacts achieved

CDA:

Successful engagement in CDA consultations regarding process changes (Feb 2026), resulting in CDA putting aside their proposal to eliminate clinician feedback on draft HTA recommendations. This helps to ensure that clinicians can provide feedback on HTA recommendations to ensure their clinical relevance and practical implementation.
On-going CNMSC and MS Canada engagement with provinces to accelerate the implementation of RIS and 1L HTA recommendations (Q2-4 2025).

Provinces:

The Nova Scotia CNMSC/MS Canada MS team worked successfully with Nova Scotia Pharmacare to establish funding of and criteria for dimethyl fumarate and teriflunomide in RIS – the first province in the country to do so!
On-going CNMSC and MS Canada engagement with provinces to accelerate the implementation of RIS HTA recommendations.
Submission to AB Blue Cross to improve access to 1L ravulizumab and 1L inebilizumab for NMOSD, including alignment of criteria with other provinces (May 2026).
On-going CNMSC and MS Canada engagement with provinces to accelerate the implementation of 1L cladribine access.
Engagement with provinces to secure case-by-case funding for 1L natalizumab, given failed negotiations at pCPA (July 2026 and on-going).

Other accomplishments

In addition to the specific accomplishments achieved for the 3 pillars of activity identified for the project, there have been several additional tangible outcomes as well as intangible benefits attained:

Stakeholder communications via on-going updates to CNMSC Drug Access Working Group Project website (see: https://cnmsc.ca/Home/DrugAccessWorkingGroupProject).
Engagement of a wide range of CNMSC members from across the country on medication access related issues.
Engagement of and creation of new relationships with key decision-makers within national as well as provincial organizations.
Engagement with medication access decision makers is providing concrete opportunities to improve patient care as well as showcase the expertise and research of CNMSC members across the country.

Continuing work under this initiative

The Drug Access Working Group Project has continued to see both progress and impact on a number of fronts. Activities in the coming year will emphasize provincial and/or national decision-maker engagement, both directly and thorough future collaborative initiatives (e.g., with MS Canada, CDA, etc.) to ensure equitable MS medication access for all Canadians.

Key areas of emphasis in 2026-2027 will be to:

Continued efforts to educate CDA and provinces regarding the impact of the 2024 McDonald criteria, using this as a lever to initiate broad dialogue regarding modernization and alignment of MS medication reimbursement criteria across the country.
Maintain and expand provincial engagement efforts, to ensure timely implementation of HTA recommendations and/or address provincial challenges in access to MS products.
Educate and engage CDA and provincial payers to improve access policies for MS medications in pediatric patients.

Project sponsors

If you have any questions about this project, please contact Michelle Eisner at CNMSC (meisner@brain.ubc.ca) and/or Dr. Judith Glennie the project manager (judith_glennie@on.aibn.com)