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A multimodal treatment approach is typically employed to slow the progression of disability and alleviate MS-related symptoms. This implies a high financial burden of MS on patients, healthcare systems and society. Our study focused on the costs that are attributable to long-term drug prescriptions in patients with MS. For this purpose, the medication plans of 728 MS patients from 3 medical centers in Germany were analyzed. Pharmaceutical pricing information was obtained from the LAUER-TAXE database in May 2024. The costs for the therapy with disease-modifying drugs (DMDs), the treatment of symptoms and the drug management of comorbidities were calculated separately. We then explored how the annual medication costs are related to clinical and demographic characteristics of the patients. Apart from the use of DMDs (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009584 patients, 80.2%), an average of 2.9 other prescribed medications were taken by the patients on a long-term basis. The annual medication costs averaged \u20ac11,788. DMDs contributed to 92.1% of the cumulative costs and explained 25.36% of the variance in total costs alone. The total costs were higher in younger patients with relapsing MS and mild to moderate disability due to their more frequent use of expensive DMDs. The costs for symptomatic medications and comorbidity medications increased with age, degree of disability and number of comorbidities. However, the large variability in the costs for individual patients could only be partly explained by regression models. Our study provides current data on the costs of prescribed medications, which are a major direct cost element in the care of MS patients. The clinical heterogeneity of the patients is reflected in a great variety in drug consumption and in a broad distribution of medication costs. The highest medication costs are incurred before the age of 50, as an early effective treatment can minimize later indirect costs of MS.\n                  <\/jats:p>","DOI":"10.1038\/s41598-025-25318-4","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T09:26:23Z","timestamp":1761557183000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cost patterns of long-term prescribed medications in patients with multiple sclerosis in Germany"],"prefix":"10.1038","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7015-3094","authenticated-orcid":false,"given":"Michael","family":"Hecker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgit","family":"Berger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4655-774X","authenticated-orcid":false,"given":"Niklas","family":"Frahm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7948-958X","authenticated-orcid":false,"given":"Felicita","family":"Heidler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bassel","family":"Barhoum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avinash Mohnish","family":"Suntah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Finn","family":"Br\u00fcggemann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Grothe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uwe Klaus","family":"Zettl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"issue":"10422","key":"25318_CR1","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1016\/S0140-6736(23)01473-3","volume":"403","author":"D Jakimovski","year":"2024","unstructured":"Jakimovski, D. et al. 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NF received travel funds for research meetings from Novartis. MG received honoraria, speaking fees and research funding from Bayer, Biogen, Bristol Myers Squibb, Johnson & Johnson, Merck, Novartis, Roche, Sanofi and Teva as well as BMBF and DFG. UKZ received research support, speaking fees and travel funds from Alexion, Almirall, Bayer HealthCare, Biogen, Bristol Myers Squibb, Janssen, Merck Healthcare, Novartis, Roche, Sanofi Genzyme and Teva as well as the European Union, BMBF, BMWi and DFG. BBe, FH, BBa, AMS and FB declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This research was conducted with approvals by the ethics committees of the University of Rostock and of the State Medical Association of Thuringia (permit numbers A 2014-0089 and A 2019-0048). The studies were performed in accordance with the principles of the Declaration of Helsinki. 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