People with MS in Albania given new hope with widening access to MS treatment

Albania is a European country, home to nearly 1000 people living with MS. Until 2022, only two disease-modifying therapies (DMTs) were available through the public system: interferons and fingolimod.

When the World Health Organization (WHO) added three MS treatments to its list of essential medicines (EML) in 2023, it made two important messages: (1) MS is a condition that should be treated, and (2) a range of DMTs should be made available, to meet the diverse needs of people with MS at different stages of their lives. In Albania, only having access to two types of treatment did not cover the needs of people whose MS was highly active, or in a progressive phase of the disease.

A bridge between patients, clinicians, and policymakers

Tanush Çaushi and colleagues at a meeting organized by Fondacioni Pema e Jetës in June 2025 on “Transforming Healthcare for Multiple Sclerosis in Albania”.

Thanks to the efforts of Fondacioni Pema e Jetës (Tree of Life Foundation) from 2022-2025, people with MS in Albania now have reimbursed access to ocrelizumab, ofatumumab, cladribine and glatiramer acetate in addition to interferons and fingolimod.

This change has substantially improved treatment choice, equity, and clinical outcomes, aligning Albania more closely with European standards of MS care.

The role of the Foundation was so important because it could connect everyone who had to collaborate to achieve this goal, whilst ensuring patient voices were central to the process:  

• MS patients and patient advocates
• Neurologists and healthcare professionals
• The Ministry of Health and Social Protection of Albania Antidiscrimination Commissioner
• National health institutions involved in reimbursement decisions
• Pharmaceutical stakeholders (in an advocacy and consultation capacity)

Fondacioni Pema e Jetës takes action

There were a number of steps that needed to happen to improve access to DMTs.

1. Preparing the evidence

The Foundation collected all the necessary evidence. This included data to show gaps in access to treatment, clinical evidence on the limitations of the two available treatments and a patient survey demonstrating the unmet needs for people with MS.

A study on the Economic Burden of Multiple Sclerosis in Albania was commissioned, because demonstrating the long-term cost-savings of effectively treating MS can be powerfully persuasive. This study showed that only 17% of people with MS in Albania were treated with DMTs (far fewer than in neighbouring countries). The direct cost of treating MS patients in 2024 was approximately €1.32 million, but the economic loss due to productivity decline and caregiver burden was estimated at more than €10.46 million – a huge difference between the cost of action and the cost of inaction.

Importantly, the evidence also included testimonies from people with MS emphasising the challenges they face when living with untreated or undertreated MS.

2. Discussion with health authorities

Meetings with the national health authority focused on the need for reimbursement to be expanded to the new treatments.

3. Raising public awareness

To influence decision-makers, it can be helpful to show you have support from the public. This is where public awareness events or campaigns come in. By educating people about the expected standards of MS treatment – and what is available in other countries – you can get support for higher standards of treatment in your country. 

4. Dialogue with decision-makers

Changes to treatment availability and reimbursement are often made by people who develop and decide on health policies. These are some of the key people that the Foundation met with, to put forward their evidence and negotiate for better treatment access for people with MS. 

5. Monitoring

Even once you have agreement that treatments will be made available and reimbursed, the work doesn’t stop. It’s important to monitor that this is translated into real difference for people with MS, tracking how access to (and reimbursement of) the new treatments is changing over time.

How did the WHO EML help?

The WHO Essential Medicines List wasn’t often cited in national policy documents. But this didn’t mean it had no influence. Getting MS treatments added to the WHO EML can be used as an important indirect influence, especially in policy or public discussions. For example, when Tanush Çaushi, the President of Fondacioni Pema e Jetës spoke on a national TV show about the lack of treatment for people with MS in the country, he emphasised the importance of following international protocols and using medications approved by the WHO.

The WHO EML can be used as evidence to:

• Strengthen the legitimacy of advocacy arguments
• Support alignment with international best practices
• Reinforce the case for equitable access to innovative therapies
• Encourage policymakers to view MS treatments as essential, not optional

What is your advice for MS organisations?

Build sustained, evidence-based advocacy that puts patients at the centre, while maintaining continuous dialogue with health authorities. Believe that patient-led organisations can drive systemic change, even in resource-constrained settings.

“Change rarely happens overnight, but persistence, credible data, and collaboration make reform possible.” Tanush Çaushi, President Fondacioni Pema e Jetës

What are the future priorities of Fondacioni Pema e Jetës?

Access to medication alone is not enough. Fondacioni Pema e Jetës remains committed to advancing comprehensive, patient-centered MS care in Albania, and is working to address:

• Multidisciplinary rehabilitation services
• Early diagnosis pathways
• Long-term sustainability of MS care
• Ensuring access for all patients, regardless of disease severity or location