OBJECTIVES: Several disease-modifying therapies (DMTs) including IFNB-1b have been approved for patients with multiple sclerosis (MS) to delay disease progression and reduce the incidence of relapses. Fingolimod, the first oral formulation of DMT, was recently approved in several nations around the world including Germany. This study aims to conduct a cost-minimization analysis to estimate the cost impact of MS treatment with Fingolimod versus INFB-1b in Germany from the societal perspective. METHODS: A Markov model is developed to follow the natural history MS patients from time of diagnosis through disease progression and up to 20 years. MS patients receive either IFNB-1b or Fingolimod treatment but share the same efficacy on disease progression and relapse rate due to the absence of head-to-head comparison data. Fingolimod patients are assumed to have 10% higher treatment adherence due to the oral formulation. In the model, DMTs costs (IFNB-1b: €19,444/year and Fingolimod: €30,584/year) are based on AVP pharmacy retail price, while other cost items are estimated from published literatures or local databases. Main model outcomes include direct costs, indirect costs, and total costs. All costs are inflated to 2010 Euros and discounted annually at 5%.  RESULTS: In the short-term analysis, Fingolimod costs additional €8,929 per patient in one year and €29,550 per patient in 5 years compared to IFNB-1b. Long-term analysis (20 years) shows that cost savings associated with IFNB-1b is €41,593 per patient, which mainly occurs when MS patients are still receiving treatment. The cost advantages of IFNB-1b in the long-term analysis are attributed to its lower drug cost (€50,342 vs. €92,873), serious adverse events management (€6.7 vs. €102.4), and clinical monitoring (€8.8 vs. €438.2). CONCLUSIONS: Compared to Fingolimod, MS treatment with INFB-1b leads to substantial cost savings from both societal and payer perspectives in Germany, with similar treatment effectiveness.