Brazil’s Public Health System Sees 26% Increase in Multiple Sclerosis Treatments

The number of patients receiving treatment for multiple sclerosis through Brazil’s public health system, the SUS, grew by 25.9 percent between 2019 and 2023, according to a study published in June in the journal Multiple Sclerosis and Related Disorders. Researchers from Hospital Israelita Albert Einstein and the Center for Studies and Promotion of Health Policies analyzed data from 27,000 patients across the country to track shifting access patterns and therapeutic approaches for the chronic autoimmune condition.

Protocol Updates and High-Efficacy Medications

Behind the growth in patient numbers is an expansion in access to advanced therapies that help preserve quality of life. Multiple sclerosis is a chronic autoimmune disease affecting the central nervous system, where the immune system attacks the myelin sheath protecting neurons, causing inflammation and lesions in the brain and spinal cord. Treatment relies on immune-modulating drugs to reduce this immune response.

Until the federal clinical protocol was updated in 2021, the SUS restricted doctors from prescribing high-efficacy medications at the start of a patient’s care journey. Patients were required to try lower-efficacy drugs first. Following the 2021 policy shift, clinicians gained the ability to prescribe high-efficacy medications earlier in the disease course.

Observamos que a prescrição de medicações de alta eficácia aumentou em todas as regiões do Brasil, mas de forma desigual e heterogênea Lívia Almeida Dutra, neurologist and study leader at the Einstein Brain Institute

Regional Disparities in Prescription Rates

Although high-efficacy treatments increased nationwide, the distribution remains uneven across Brazilian states. Researchers point to several potential bottlenecks in the public health infrastructure that may explain the regional gap. These factors include difficulties within local healthcare networks in performing detailed diagnostic scans, a lack of dedicated infusion centers for specialized drug administration, and occasional disruptions in medication dispensing logistics.

According to Dutra, overcoming these disparities requires targeted investments in local healthcare structure and specialized staff training.

Barriers to Early Diagnosis

Another major hurdle identified by medical specialists is the delay in obtaining an initial diagnosis. Because multiple sclerosis symptoms depend on where inflammation occurs in the central nervous system, patients often present with varied motor, neurological, or functional signs such as muscle weakness, balance problems, visual changes, or sphincter control issues.

A demora no diagnóstico ocorre pela demora na realização de exames complementares, como a ressonância magnética de crânio, que é o principal exame que comprova a presença das lesões cerebrais e medulares Claudia Vasconcelos, neurologist with the Brazilian Academy of Neurology

Vasconcelos, who is also a professor at the Federal University of the State of Rio de Janeiro, notes that early symptoms are occasionally misinterpreted within primary care settings as anxiety or orthopedic issues, delaying specialist referral. Specialists advocate for expanding patient access to cranial magnetic resonance imaging, cerebrospinal fluid analysis, and biomarker tests. These tools help confirm diagnoses and track both disease progression and treatment response before patients suffer repeated inflammatory attacks.