21 Patient-Centered Care and the DMTs Selecting your DMT can be a complex decision. Right now, there’s no way to determine which will work best for you except trial and error. However, each drug carries different risks and benefits. How often the medication is taken, how it is administered, your medical history, other medications you take, and whether you want to treat the disease aggressively or cautiously are all factors to be considered. Ideally, you and your doctor will discuss the options together and arrive at a plan through shared decision-making. And if the DMTyou select together is not effective for you or has intolerable side effects, you will discuss what’s needed to transition off one DMT and on to another. However, sometimes insurance concerns get in the way. Insurance companies may choose to limit which MS medications are available on a plan, or require “step therapy,” where certain (typically less expensive) medications must be tried first. Step therapy requirements can also cause difficulties when you switch insurance plans. A medication that is proving effective for you may not be covered unless you have previously tried and been failed by other medications. MS Focus believes that people with MS and their doctors should have access to all FDA-approved treatments without hindrance. Together with our partners in the MS Coalition, we advocate for insurance providers, both public and private, to ensure broad access to the full range of available treatments. If you encounter a roadblock to getting your DMT approved by insurance, we encourage you and your doctor to appeal. The MS Coalition has prepared resources to assist. Visit www.ms-coalition.org to learn more. Learn More EmpowerSource A quarterly publication featuring support groups and advocates around the country, this MS Focus newsletter shares activities and ideas of members of our national community, plus information about outreach, advocacy, and living positivelywith MS. National Toll-Free Helpline Through personal contact, dedicated Support Services Coordinators and peer counselors provide you information, referrals, and assistance in accessing services from MS Focus and within your community. The Use of Disease-Modifying Therapies in Multiple Sclerosis: Principles and Current Evidence The purpose of this MS Coalition paper is to summarize current evidence about disease modification in MS and provide support for broad access to U.S. FDA- approved MS disease-modifying therapies for people with MS.