12 Choosing a DMT MS is a complicated disease and there is no one-size-fits-all approach to treatment. When choosing a disease-modifying treatment, a variety of factors must be taken into consideration. These include: • Administration — is the treatment a pill, an injection, or an infusion? • Frequency — options range from daily to yearly • Effectiveness — there are few head-to-head comparisons available, so your doctor’s experience with prescribing the medication to others may come into play • Side effects — all DMTs have side effect risks, but some are more serious than others • Contraindications — Do you have other health conditions that would rule out certain medications? When deciding on a first medication, or switching to a new medication, you and your doctor need to discuss your personal situation. For example, your doctor might assume you would prefer a monthly infusion performed in a center rather than having to inject yourself regularly at home, but you might have difficulty getting time off work to go to an infusion center. If you’re female, your doctor might suggest a treatment that has fewer risks for pregnancy, but perhaps you’ve never wanted children and would prefer a more aggressive treatment. Examples like these show why it’s important that you discuss how a recommended treatment will fit into your life. Here are some questions to ask when your doctor recommends a treatment: 1. Why are you recommending this treatment over the others? 2. How aggressive do you consider this treatment to be compared to other MS treatments? 3. What are the potential side effects of this treatment? 4. Is this a treatment I take at home? If not, where will I go and how long will it take? 5. Should I know anything about pregnancy or family planning with this treatment? 6. Does my insurance cover this treatment? Will it need to be preauthorized? 7. Do I have to wait for other medications to get out of my system before I can start this one? Or if I have to change later, will I have to wait for this to get out of my system? 8. Are there any additional concerns about the medication I need to be aware of? For example, does it have to be ordered from a specialty pharmacy, or does it need to be refrigerated? Selecting a DMT can be difficult, and sometimes you may have to try several medications before you find the one that is effective for you. But by taking the time to carefully discuss your treatment options with your doctor, you will have the best chance of success.