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In India or the US – MS Treatment is Still Costly

I’m not sure which part of a recent news story I want to share first because both aspects make me angry, and again I feel frustration at knowing treatment for Multiple Sclerosis is available, but not all people are given the opportunity to put up a fight due to costs.

The story comes from India, where it is estimated that 100,000-200,000 people have MS, but most of them are never offered treatment. The reason seems to be two-fold – one is the cost and the other is the lack of medical information literacy.

First the article points out that there is a lack of knowledge about treatment options and the Disease Modifying Therapies (DMTs), among both physicians and the people with MS. The stories say that DMTs have been available in India for 15 years, which puts it behind the US and the Western world by just a few years.  The newer oral MS drugs have not yet been approved for use in India, but appear to be poised for approval in the next year or two.  The same stories go on to say that the majority of people with MS in India never receive treatment for their disease.

India is known as one of the leading manufacturing sites in the world for pharmaceutical drugs and is also a leader in the biotech industry, but unable or unwilling to treat this large MS population. India is positioned as the 4th largest economy in the world, and it is just wrong that 100-200,000 people in India are not offered the chance to slow the progression of this disease.

It is no surprise that the per capita income in India is quite low, even though it has risen much faster than other places in the world, thanks to its strong economic growth rate.  The per capita income in India is now estimated at just short of  6,000 Rupees per month. Before you get excited about that large number for income, do the currency conversion and you will find it equals about $90 US a month. That means the per capita income for a family of 4 would be less than $400 a month, but the reality is an even great percentage of people live on much less than that.

It appears that India is also known for its anemic or often non-existent health insurance and people without good coverage or who have none at all, usually go without treatment for Multiple Sclerosis.  The typical cost of the injectable treatments for MS in India is around 27,000R per month, about $400 US. The income of the average Indian family of four would have to all be used to treat the person with MS and it is unlikely that a family would use all of its resources to get treatment, when they would still need the basics of food, clothing and shelter.  Hence most of the MS population in India remains untreated.

I don’t believe the pharmaceutical company patient assistance plans we have here in the United States exist in India. I’m not sure about other countries, but I’m thinking the US market is a special situation. We  also can’t buy any of the current DMT’s approved for use in the United States for $400 – our prices are easily ten times that amount.

The escalating costs of DMTs in the United States are also out of proportion to what the average income might be.  Recent estimates of the average income in the United States for a family of four is approximately $52,000.  Current annual pricing for a few of our MS drugs includes Aubagio at $48,000, Tecfidera costs $55,000, and Gilenya for $60,000. Copaxone, one of the oldest MS drugs in use is now running about $50,000 a year. If a person in the US has to choose between treatment at these costs or the basics of food, clothing and shelter, we are no better off than the people in India with Multiple Sclerosis.

Because these are averages that use the income of the super-rich as part of the numbers, I would venture a guess that so many people with MS, both in the US and India, live on incomes well below these averages.

I started this blog with two points in mind – the first being the lack of knowledge about MS in India is hurting the patients there.  The second was going to be about how the people in India can get these drugs for about $400 and why is that so much less than what is charged in the United States.

The more I wrote and researched the numbers, a third point slowly emerged – when it comes to comparing costs in India versus the United States, is there really such a difference after all? How do we get these essential treatment drugs to people with MS, no matter where they live, without forcing them into spending their entire income in exchange for their health?   It seems to be a universal question – now we need to find an answer.

wishing you well,


This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Pradeepms76
    8 months ago

    Thanks to Laura for authoring this article regarding the right and affordability of MS treatment in USA & India. I am living with MS since 2009 and have been on Avonex Inj till then. Though i was aware of branded tablets like Amypra that helps in imbalance and walking. I was not able to get it here nor able to afford it.

    I am now happy that the long wait to get the generic medicines are over. I can see a ray of hope, we are catching up with developed countries.

    Now since 2018, we are able to get Dalfampridine DalStep 10mg Extended tablets an alternative of Ampya in India. Also i am looking forward to quickly switch from Avonex Inj to Teriflunamide (Teru MS 14mg) tablets daily once now at affordable price.

    Hope this information will be helpful.

  • Amit
    6 years ago

    MS, is a chronic life time illness and with the patients in India estimated to be between 100,000-2,00,000; it is high time that Indian Health Ministry gave a serious thought to it. While it is okay to let a situation assume endemic proportions before taking concrete action on it; it is not so with the illness of Multiple Sclerosis which is the no.1 reason for disability in young adults.- a lifelong health issue, an issue that directly interferes with the patient’s fundamental right to live an independent life, a life of purpose, a life of dignity and non-discrimination, a life of support rather than sympathy.
    Are we waiting for every 3rd,4th or 5th patient to be suffering from MS before we take it on priority and give maximum import duty concessions on the highly costly MS medication/injectables?
    Are we waiting for processions, dharnas, mass burials to take place before giving maximum concessions to local pharma companies to produce and make available the MS drugs at the least cost?
    Are we really progressing when we let die our own countrymen for want of medication due to unaffordability?
    Are the people in power aware that each and every MSer is as bright as, if not brighter, than any other candidate in his chosen area of specialization?
    I believe that pen is mightier than the sword,and hope fellow MSers would use their pen too to shake the government from inertia and make them do something drastic, positive and immediate for welfare of the patient community.

  • Laura Kolaczkowski author
    6 years ago

    Amit, thank you for the comments. As I said in my blog, this is a problem on so many levels but most of all, there are people with MS who should be getting treatment now, and don’t – primarily because of the costs. And that doesn’t seem to matter where we live – the US or India. I hope you can help to wake up the community and get them to speak up in India to bring about change. best, Laura

  • Kim Dolce moderator
    6 years ago

    No doubt the pharma companies are lobbying our elected officials to discourage them from considering price caps on biologic drugs and shorter expiration dates on patents that would allow lower cost generics to be offered to patients struggling with medical debt. Seems to be a vicious cycle of cranking up prices, which stresses poor patients into non-compliance, which then further raises the cost of drugs/health care.

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