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  1. Roger Mills1,
  2. Carolyn Young2,
  3. on behalf of TONiC Investigators1
  1. 1 Royal Preston Hospital
  2. 2 The Walton Centre


Patients with MS are drawn from every stratum of society. It is important that patients have equitable access to disease modifying treatments (DMT). Patient registry data on 3490 subjects from 16 centres in England from the past 26 months of the TONiC study were aligned, by postcode, with indices of deprivation, from the Office of National Statistics. These indices and disease factors were cross-tabulated with DMT usage. The sample's sex and disease type distribution were representative of a typical MS population. 53% were on DMT (22% injectables, 13% natalizumab, 9% orals, 9% other). 92% of rapidly evolving, 63% of relapsing remitting and 21% of progressive patients were on DMT. 25% of patients EDSS 7.0–7.5 and 9% of patients EDSS 8.0–9.5 were on DMT although this was only 1.8% of the total sample. There was no difference in DMT usage by income, employment, education skills and training, crime level, or geographical barriers. Fewer patients in areas of high health deprivation (p=0.01) and with barriers to housing services (clear trend, p=0.05) were on DMT. English DMT usage seems equitable and is largely in accordance with ABN criteria but discrepancies are discussed.

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