2025 Réalisations: projet du groupe de travail sur l'accès aux médicaments du CNMSC

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 a national as well as a provincial level. 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: Biogen Canada Inc., EMD Serono Inc., Novartis Pharmaceuticals Inc., Hoffman-LaRoche Limited, and Amgen. 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 December 2025) 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	Active clinician input and feedback into the review process, contributing to positive HTA review recommendations for both dimethyl fumarate and teriflunomide in Radiologically Isolated Syndrome (RIS) (February 2025) Significant contributions to the 1L reviews for cladribine, natalizumab in RRMS<3 A List of Essential Prescription Drugs and Related Products: Initial Recommendation (July 2025) Evolving Clinician Group Input Submissions Into the Drug Reimbursement Review Process (September 2025) Input on other CDA consultations CDA and provinces agreed to this review through the newly created Formulary Management Expert Committee (FMEC) process CNMSC input submission to improve clinical relevance of project scope (Aug 2024) Proactive engagement of CDA regarding the impact of the 2024 McDonald criteria (October 2025)
Provincial engagement activities	Leverage learnings from Ontario MS initiative to modernize access criteria and improve access processes for MS medications in other provinces	MS medication access policy change in Saskatchewan DMT renewal period extended to 24m (February 2025) MS medication access policy change in Nova Scotia NMSC’s Summer 2024 submission requesting extended renewal periods was adopted by Nova Scotia Pharmacare as of October 1, 2025. Initial approvals will now be for 2 years and the renewal period will be 5 years This change improves patient access and decreases administrative burden on both clinicians and drug plan staff. General review and simplification of DMT criteria in collaboration with NS Pharmacare staff (June 2025) On-going: Collaboration with MS Canada Quebec team re: raising awareness re: 2024 McDonald criteria (when published); analysis of potential implications of new criteria for HTA bodies, provincial drug programs, etc.
Pediatric access activities	Research and publications regarding pediatric DMT access and/or challenges HTA and public payer engagement strategy to improve pediatric DMT access	Publications: Consensus paper re: 1L use of high-efficacy therapies in MS (June 2025)4 Scoping review of uptake of DMTs in children and adolescents with MS in Canada and internationally (March 2025)5 Review paper outlining barriers to treatment for pediatric MS and identification of future directions for equitable access (September 2025)6 Canadian survey of access to DMTs for pediatric MS and identification of potential policy solutions 7 Funding of Canadian Pediatric Neuroinflammatory Disorders Registry (A. Yeh, et al) under the CDA Rare Disease Registry Funding Opportunity (November 2025) Engagement of CDA to address pediatric MS medication access challenges (December 2025)

Policy impacts achieved

CDA:

• Positive HTA reviews for dimethyl fumarate and teriflunomide in RIS, as well as 1L cladribine and natalizumab in RRMS – both opening up opportunities to provide therapy to PLWMS in alignment with the most current evidence.
• On-going CNMSC and MS Canada engagement with provinces to accelerate the implementation of RIS and 1L HTA recommendations (Q2-4 2025)

Nova Scotia:

• The CNMSC/MS Canada MS team in Nova Scotia have 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!⁸

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 relatedissues.
• 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 patientcare 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 will be to:

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

Project sponsors