At least one pharmacy benefits manager says the new oral multiple sclerosis drugs are starting off on the right foot with smart pricing and the potential to improve adherence over injectable standard of care. If they want to oust injectables from the top spot on most formularies, the oral entrants will need to avoid steep price increases and produce longitudinal data proving their benefits.

Oral drugs for relapsing-remitting multiple sclerosis (RRMS) started to come online in October 2010 when Novartis AG launched Gilenya fingolimod. Aubagio teriflunomide from Sanofi's Genzyme Corp. unit came next, in August 2012, followed this April by Tecfidera dimethyl fumarate from Biogen Idec Inc.