The NHS in England use an algorithm for the treatment options in MS (PDF, 535KB). This describes how each licenced disease modifying drug (DMD) can be prescribed, depending on the type of MS you have and how it has responded to treatment so far.
The algorithm is also presented as a flow chart (PDF,280KB) which describes your initial drug options, and then what you can switch to if those drugs are ineffective or you find the side effects are intolerable. The guidance documents for the algorithm also discuss definitions for many MS terms, and the circumstances under which DMD treatment should be switched or stopped.
NHS England state that this algorithm should help decision making by both patients and health professionals, as well as reducing inequality in MS treatment across England. They also state that everyone should have access to the same licenced DMDs, at the right time for them, and that the patient should be at the heart of any MS prescribing service.
Many patient, health professional and advocacy groups, including the MS Trust, made considered comments to the NHS Neurosciences consultation body, which also oversees guidelines for service specification and other policies.
Neurologists in Scotland may follow similar guidelines, but may have more flexibility in practice.
