In a discussion moderated by Dr. Fred Lublin, Drs. Patricia K Coyle, Leslie Fish, and Gary M. Owens share their insights and perspectives on the increasing prevalence and incidence of multiple sclerosis (MS) worldwide, despite great clinical strides in recent years. United States is recognized as a high-risk zone for developing MS, and although previous estimates suggested that the US was limited to approximately 400,000 cases of MS, new data indicates that the prevalence may actually be closer to 750,000. MS tends to strike individuals during their peak productive years, causes chronic disability, and is associated with heavy disease and economic burden. As such, it is vital to expand the discussion of managed care strategies while continuing the exploration for optimal therapeutic amidst an evolving drug pipeline for MS.