Public consultation

There are 2.8 million people living with MS but many people do not have access to disease modifying therapies (DMTs). The DMTs may simply not be available or too expensive for the person with MS. In 7 out of 10 countries people face barriers in accessing treatment. There is an urgent need to make MS treatments available in all health systems.

To ensure an evidence-based approach for advocacy, MSIF convened an international multi-disciplinary panel, the MSIF Essential Medicines Panel (MEMP), which made recommendations on essential MS DMTs for low-resource settings. The Cochrane MS Group systematically retrieved and evaluated the evidence and the panel made judgments using the GRADE evidence-to-decision (EtD) framework, facilitated by the GRADE McMaster Centre. These MEMP recommendations were considered together with MSIF’s Off-Label Treatments (MOLT) guidelines to propose MS DMTs on the World Health Organization essential medicines list.

The recommendations are now open for public comment until 27th of January 2022: http://www.msif.org/wp-content/uploads/2023/01/MEMP_EtD-and-recommendations_public_201222.pdf

In addition, we have prepared
- A scope document explaining the purpose of the recommendations
- A Frequently Asked Questions (FAQs) document to give more context to the recommendations

Please note that due to the potential large number of comments, we are unable to provide individual replies. We will aim to consider all potential errors in the evidence reviews.

Background documents

The Cochrane systematic review protocols can be found here:
Relapsing forms of MS (RMS): Forthcoming updated version of https://doi.org/10.1002/14651858.CD011381 
Progressive forms of MS (PMS): https://doi.org/10.1002/14651858.CD015443
Rapid systematic review protocol for acceptability, equity, feasibility, and values: https://osf.io/w9gs8/

The MEMP EtD for RMS can be accessed on https://www.msif.org/documents-memp-etd/ and here.

The MEMP EtD for PMS can be accessed on https://www.msif.org/documents-memp-etd/ and here.

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* 1. Which of the following options best describe your role in relation to this guideline? Please select all that apply.

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* 2. Which country’s perspective are you commenting from?

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* 3. Please outline any conflict-of-interest you may have in relation to these guidelines, both financial and intellectual.

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* 4. Is there anything important that we have not included or any errors that you have noted?

Please ensure to check the links provided for the full details of the evidence used and decision-making process of the MSIF Essential Medicines Panel [MEMP]. For any points raised, please make sure to include details of the specific PICO and EtD field where information is lacking or incorrect. Please note the evidence is gathered using a systematic review protocol which has inclusion and exclusion criteria, links to the protocols have been provided.

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* 5. Is there any context or background we should make sure to include in the final peer reviewed publication?

Please include reasons why this particular point needs to be included or emphasized.

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* 6. Do you have any suggestions on how these recommendations should be disseminated?

Please share any relevant experience you may have from low-resource settings to help us consider implementation of these guidelines.

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