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For US healthcare professionals only.

The Above MS™ program from Biogen is here for patients with tips, tools, and information for their relapsing multiple sclerosis—and so much more.

Nurse Educators

Whether your patients are just starting therapy or have been on therapy for a while, Nurse Educators are there to provide additional support for patients and their care partners and answer questions they may have. Along with you, Nurse Educators can offer patients ongoing support throughout therapy.

Nurse Educators can be a great resource for your patients. However, your patients should always come to you with any questions related to their relapsing MS and their treatment.

Nurse Educators are available throughout the United States, as needed, to offer phone counseling:

  • Nurse Educators can provide additional support regarding your patients’ questions about relapsing MS, common symptoms, and side effects
  • Nurse Educators can provide your patients with support through relapsing MS education, help them plan for their next doctor visit, and connect them with the services and support that are available to them. Your patients can call 1-800-456-2255 to connect with a Nurse Educator 24 hours a day, 7 days a week

About Nurse Educators:

  • Biogen wants patients to feel confident that the additional educational support they may choose to receive is from nurses who are knowledgeable and highly educated in MS and many are MS certified or working toward their MS certification. A Nurse Educator can help your patients by sharing information on the services and support available to them
  • These nurses are available day or night. They are familiar with the challenges your patients may be facing with relapsing MS, as well as how to support them throughout their journey  

Support Coordinators

As your patients continue on a relapsing MS therapy as prescribed by you, they may need extra support. For patients taking a Biogen relapsing MS treatment, our Support Coordinators can help them understand and access the resources they may need along their journey with relapsing MS.

The Support Coordinators from Biogen offer a broad range of services:

  • General relapsing MS information
  • One-on-one relapsing MS support over the phone
  • Tips to support living with relapsing MS
  • Insurance Benefit Investigation and researching financial assistance options
  • Recommendations for free educational events in their area that allow your patients to learn from experts and other people living with relapsing MS
  • Follow-up calls as necessary

Peer Community

People living with relapsing MS are not alone with support from the Peer Community from Biogen.

Relapsing MS may change the way your patients manage their lives, but it doesn’t have to change their outlook on life. Patients can search our Peer Community and find someone who knows what it’s like to live with relapsing MS. Call 1-800-456-2255.

Financial & Insurance Support

Get financial and insurance support for your patients’ relapsing MS treatment. The AboveMS™ program from Biogen gives patients access to Support Coordinators who can help them understand their insurance coverage and try to identify the best financial assistance solution for them. Our goal is that no one has to forego treatment based solely on financial limitations.

Financial and insurance services include:

  • Benefit Investigation to clarify your patients’ coverage options
  • Insurance counseling to help patients understand their coverage, along with help navigating changes due to the healthcare reform law
  • $0 Copay Program with no income requirements and no enrollment time limit for eligible patients.a Patients can call 1-800-456-2255 to see if they’re eligible
  • Copay Assistance Program for eligible patientsb
  • Free Drug Program for eligible patients in need
  • Support finding assistance through charitable organizations

To learn more about the financial services offered, patients can call one of our Support Coordinators at 1-800-456-2255, Monday through Friday, 8:30 AM to 8 PM ET.

aDepending on patients’ income or, in some cases, if their medication is obtained from an out-of-network provider, there may be an annual cap that limits the amount of assistance that they can receive over one year. Federal and state laws and other factors may prevent or otherwise restrict eligibility. People covered by Medicare, Medicaid, the VA/DoD, or any other federal plans are not eligible to enroll.

bPatients will be responsible for any cost associated with their infusion above the $100 per infusion assistance provided by the program. In order to participate in the program and get assistance, they must still meet the following requirements:

  • Patients have a financial responsibility or copay for their infusion
  • Patients are not a resident of Massachusetts, Michigan, Minnesota, or Rhode Island
  • Patients are not covered by any federal healthcare program, like Medicare, Medicaid, the VA/DoD, or TRICARE®, and/or state medical or pharmaceutical assistance programs. Patients agree to tell Biogen immediately if they obtain coverage through programs listed above
  • Patients are using TYSABRI as described in the FDA-approved label

TRICARE is a registered trademark of the Department of Defense, Defense Health Agency. All rights reserved.


$0 Copay Program

With the $0 Copay Programa from Biogen, your patients pay $0 a month for their relapsing MS medication if eligible.

The $0 Copay Program has:

  • No income requirementsa—eligible patients can enroll in the $0 Copay Program regardless of income
  • No time limit—your patients can re-enroll every year for as long as they’re taking the medication
  • No waiting—your patients’ specialty pharmacies can enroll them immediately into the program so they can get their relapsing MS medication right away

a$0 Copay details and eligibility:

  • Please note that the $0 Copay Program provides a monthly supply of relapsing MS medication. Your patients are eligible to enroll in the $0 Copay Program for as long as they are treated with a Biogen relapsing MS medication
  • Federal and state laws may prevent eligibility. People covered by Medicare, Medicaid, the VA/DoD, or any other federal plans are not eligible to enroll. In addition, some insurance providers may prevent eligibility or restrict eligibility to people with demonstrated financial need. If your patients are not eligible or not sure of their eligibility, they should call 1-800-456-2255. There are charitable programs and even a free drug program sponsored by Biogen that may be able to help your patients with the cost 

Depending on your patients’ income or, in some cases, if their medication is obtained from an out-of-network provider, there may be an annual cap that limits the amount of assistance that your patients can receive during a year.

Encourage patients to call the Above MS hotline

If your patients have any questions or want to learn more, they can call 1-800-456-2255 Monday to Friday, 8:30 AM to 8 PM ET, or visit


WARNING: Progressive Multifocal Leukoencephalopathy (PML)

TYSABRI® (natalizumab) increases the risk of PML, an opportunistic viral infection of the brain that usually leads to death or severe disability. Risk factors for the development of PML include duration of therapy, prior use of immunosuppressants, and presence of anti-JCV antibodies. These factors should be considered in the context of expected benefit when initiating and continuing treatment with TYSABRI.

Healthcare professionals should monitor patients on TYSABRI for any new sign or symptom that may be suggestive of PML. TYSABRI dosing should be withheld immediately at the first sign or symptom suggestive of PML. For diagnosis, an evaluation including a gadolinium-enhanced MRI scan of the brain and, when indicated, cerebrospinal fluid analysis for JC viral DNA are recommended.

Because of the risk of PML, TYSABRI is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the TOUCH Prescribing Program.

  • Infection by the JC Virus (JCV) is required for the development of PML.
  • There are no known interventions that can reliably prevent PML or that can adequately treat PML if it occurs.
  • Postmarketing data suggest that the risk of developing PML may be associated with relative levels of serum anti-JCV antibody compared to a calibrator as measured by ELISA (often described as an anti-JCV antibody index value).
  • MRI findings may be apparent before clinical signs or symptoms suggestive of PML. Monitoring with MRI for signs that may be consistent with PML may be useful, and any suspicious findings should lead to further investigation to allow for an early diagnosis of PML, if present. Consider monitoring patients at high risk for PML more frequently. Lower PML-related mortality and morbidity have been reported following TYSABRI discontinuation in patients with PML who were initially asymptomatic compared to patients with PML who had characteristic clinical signs and symptoms at diagnosis.
  • PML has been reported after discontinuation of TYSABRI in patients who did not have findings suggestive of PML at the time of discontinuation. Patients should continue to be monitored for any new signs or symptoms that may be suggestive of PML for approximately 6 months after discontinuation of TYSABRI.
  • Adverse events that may occur during plasma exchange include clearance of other medications and volume shifts, which have the potential to lead to hypotension or pulmonary edema. Although plasma exchange has not been studied in TYSABRI-treated patients with PML, it has been used in such patients in the postmarketing setting to remove TYSABRI more quickly from the circulation.
  • JCV infection of granule cell neurons in the cerebellum, i.e., JCV granule cell neuronopathy (GCN), with symptoms similar to PML, has been reported in patients treated with TYSABRI. JCV GCN can occur with or without concomitant PML and can cause cerebellar dysfunction. Diagnosis and management of JCV GCN should follow guidance provided for PML.
  • Immune reconstitution inflammatory syndrome (IRIS) has been reported in the majority of TYSABRI-treated patients who developed PML and subsequently discontinued TYSABRI. In almost all cases, IRIS occurred after plasma exchange was used to eliminate circulating TYSABRI. It presents as a clinical decline in the patient’s condition after TYSABRI removal (and, in some cases, after apparent clinical improvement) that may be rapid, can lead to serious neurological complications or death, and is often associated with characteristic changes in the MRI. TYSABRI has not been associated with IRIS in patients discontinuing treatment with TYSABRI for reasons unrelated to PML. In TYSABRI-treated patients with PML, IRIS has been reported within days to several weeks after plasma exchange. Monitoring for development of IRIS and appropriate treatment of the associated inflammation should be undertaken.


  • TYSABRI is contraindicated in patients who have or have had PML.
  • TYSABRI is contraindicated in patients who have had a hypersensitivity reaction to TYSABRI. 

TYSABRI TOUCH Prescribing Program

  • Because of the risk of PML, TYSABRI is available only through a restricted distribution program under a REMS called the TOUCH® Prescribing Program.
  • Patients must be enrolled in the TOUCH Prescribing Program, read the Medication Guide, understand the risks associated with TYSABRI, and complete and sign the Patient-Prescriber Enrollment Form.

Herpes Infections – Encephalitis, Meningitis and Acute Retinal Necrosis

  • TYSABRI increases the risk of developing encephalitis and meningitis caused by herpes simplex and varicella zoster viruses.
  • Serious, life-threatening, and sometimes fatal cases have been reported in the postmarketing setting in multiple sclerosis patients receiving TYSABRI.
  • The duration of treatment with TYSABRI prior to onset ranged from a few months to several years.
  • Monitor patients receiving TYSABRI for signs and symptoms of meningitis and encephalitis. If herpes encephalitis or meningitis occurs, TYSABRI should be discontinued, and appropriate treatment for herpes encephalitis/meningitis should be administered.
  • Patients being administered TYSABRI are at a higher risk of acute retinal necrosis (ARN), a fulminant viral infection of the retina caused by the family of herpes viruses. Patients with eye symptoms such as decreased visual acuity, redness or eye pain should be referred for retinal screening as serious cases of ARN can lead to blindness of one or both eyes.
  • Following clinical diagnosis of ARN, consider discontinuation of TYSABRI.


  • Clinically significant liver injury, including acute liver failure requiring transplant, has been reported in patients treated with TYSABRI in the postmarketing setting.
  • Signs of liver injury, including markedly elevated serum hepatic enzymes and elevated total bilirubin, occurred as early as six days after the first dose; signs of liver injury have also been reported for the first time after multiple doses.
  • TYSABRI should be discontinued in patients with jaundice or other evidence of significant liver injury (e.g., laboratory evidence).

Hypersensitivity/Antibody Formation

  • Hypersensitivity reactions have occurred in patients receiving TYSABRI, including serious systemic reactions (e.g., anaphylaxis) which occurred at an incidence of <1%.
  • Reactions usually occur within 2 hours of the start of the infusion. Symptoms associated with these reactions can include urticaria, dizziness, fever, rash, rigors, pruritus, nausea, flushing, hypotension, dyspnea, and chest pain.
  • If a hypersensitivity reaction occurs, discontinue administration of TYSABRI and initiate appropriate therapy. Patients who experience a hypersensitivity reaction should not be re-treated with TYSABRI.
  • Hypersensitivity reactions were more frequent in patients with antibodies to TYSABRI compared with patients who did not develop antibodies to TYSABRI in both MS and CD studies.
  • Patients who receive TYSABRI for a short exposure (1 to 2 infusions) followed by an extended period without treatment are at higher risk of developing anti-natalizumab antibodies and/or hypersensitivity reactions on re-exposure, compared to patients who received regularly scheduled treatment.


  • The immune system effects of TYSABRI may increase the risk for infections.
  • In Study MS1, certain types of infections—including pneumonias and urinary tract infections (including serious cases), gastroenteritis, vaginal infections, tooth infections, tonsillitis, and herpes infections—occurred more often in TYSABRI-treated patients than in placebo-treated patients. One opportunistic infection, a cryptosporidial gastroenteritis with a prolonged course, was observed in a patient who received TYSABRI in Study MS1.
  • In Studies MS1 and MS2, an increase in infections was seen in patients concurrently receiving short courses of corticosteroids. However, the increase in infections in TYSABRI-treated patients who received steroids was similar to the increase in placebo-treated patients who received steroids.
  • In a long-term safety study of patients, opportunistic infections (pulmonary mycobacterium avium intracellulare, aspergilloma, cryptococcal fungemia and meningitis, and Candida pneumonia) have been observed in <1% of TYSABRI-treated patients.
  • Concurrent use of antineoplastic, immunosuppressant, or immunomodulating agents may further increase the risk of infections over the risk observed with use of TYSABRI alone.
  • In Studies MS1 and MS2, the rate of any type of infection was approximately 1.5 per patient-year in both TYSABRI-treated patients and placebo-treated patients.
  • In Study MS1, the incidence of serious infections was approximately 3% in TYSABRI-treated patients and in placebo-treated patients. Most patients did not interrupt treatment with TYSABRI during infections.

Laboratory Test Abnormalities

  • In clinical trials, TYSABRI was observed to induce increases in circulating lymphocytes, monocytes, eosinophils, basophils, and nucleated red blood cells. Observed changes persisted during TYSABRI exposure, but were reversible, returning to baseline levels usually within 16 weeks after the last dose. Elevations of neutrophils were not observed. TYSABRI induces mild decreases in hemoglobin levels (mean decrease of 0.6 g/dL) that are frequently transient.

Adverse Reactions

  • The most common adverse reactions reported at an incidence of ≥10% with TYSABRI and ≥2% difference with placebo were headache (38% vs 33%), fatigue (27% vs 21%), infusion reactions (24% vs 18%), urinary tract infections (21% vs 17%), arthralgia (19% vs 14%), depression (19% vs 16%), pain in extremity (16% vs 14%), rash (12% vs 9%), gastroenteritis (11% vs 9%), and vaginitis (10% vs 6%).
  • The most frequently reported serious adverse reactions in Study MS1 were infections (3.2% vs 2.6% placebo), including urinary tract infection (0.8% vs 0.3%) and pneumonia (0.6% vs 0%), acute hypersensitivity reactions (1.1% vs 0.3%, including anaphylaxis/anaphylactoid reaction [0.8% vs 0%]), depression (1.0% vs 1.0%, including suicidal ideation or attempt [0.6% vs 0.3%]), and cholelithiasis (1.0% vs 0.3%).
  • Based on animal data, TYSABRI may cause fetal harm. TYSABRI should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Please see full Prescribing Information including Boxed Warning.