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Agency for Care Effectiveness
Drug guidance

Disease-modifying therapies for treating multiple sclerosis

Condition

Blood and Immune System

Neurology

1 July 2026

Published on 04 Jan 2022
Last Updated on 01 Jul 2026

Guidance Recommendations

The Ministry of Health's Drug Advisory Committee has recommended:

  • Cladribine 10 mg tablet for treating relapsing-remitting multiple sclerosis, 

  • Fingolimod 0.25 mg and 0.5 mg capsules for treating relapsing-remitting multiple sclerosis, and    

  • Siponimod 0.25 mg and 2 mg tablets for treating adults with secondary progressive multiple sclerosis with active disease evidenced by relapses or imaging features of inflammatory activity. 

Funding status

Cladribine 10 mg tablet is recommended for inclusion on the Medication Assistance Fund (MAF) for the abovementioned indication from 1 September 2026. 

Fingolimod (Gilenya) 0.25 mg and 0.5 mg capsules are recommended for reclassification from the MAF to the Standard Drug List (SDL) from 1 September 2026.  

Siponimod 0.25 mg and 2 mg tablets are recommended for inclusion on the MAF for the abovementioned indication from 4 January 2022.  

SDL subsidy and MAF assistance do not apply to any formulations or strengths of alemtuzumab, dimethyl fumarate, interferon beta-1a, natalizumab, ocrelizumab, ofatumumab or teriflunomide for treating adults or children with any form of multiple sclerosis. 

Disease-modifying therapies for treating multiple sclerosis (Updated 1 July 2026) [PDF, 237.85 KB]

Plain English Summary

Multiple sclerosis (MS) is a chronic condition where the immune system mistakenly attacks the brain and spinal cord, causing damage to the nerves. MS affects each person differently. Common symptoms include fatigue, slurred speech, numbness or tingling, problems with movement (such as poor coordination or difficulty walking), blurred vision, problems controlling the bladder, and difficulties with thinking, concentration and memory.

Most people have relapsing-remitting MS (RRMS), which involves episodes of new or worsening symptoms, known as relapses, followed by periods of recovery with few or no symptoms (remission). Over time, RRMS can develop into secondary progressive MS (SPMS), where relapses occur less often but symptoms gradually worsen.

Several medicines are used to treat MS. Fingolimod and siponimod are sphingosine 1-phosphate receptor modulators which prevent certain white blood cells from reaching the brain and spinal cord, helping to reduce nerve damage. Cladribine is an immunosuppressant which helps to calm the immune system. These medicines are taken orally.

Cladribine, fingolimod, and siponimod were recommended for government subsidy because their benefits in treating certain patients with MS justify their cost.

  • Fingolimod is included on the Standard Drug List (SDL) with treatment costs subsidised by 50% to 75% for eligible patients.

  • Cladribine for RRMS, and siponimod for SPMS are included in the Medication Assistance Fund (MAF), with treatment costs subsidised by 40% to 75% for eligible patients.

Alemtuzumab, dimethyl fumarate, interferon beta-1a, natalizumab, ocrelizumab, ofatumumab and teriflunomide were not recommended for subsidy because their benefits do not justify their costs.

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