OBJECTIVES: To appraise the literature relating adherence and other patients’ reported outcomes (PROs) to Multiple Sclerosis (MS) costs.   METHODS: Electronic databases [MedLine/PubMed, Google Scholar, Congress proceedings] were searched to identify publications analyzing MS costs related to adherence, persistence, satisfaction and preferences for MS treatments. Bibliographic references were hand searched. English or Spanish studies published between January 2007 and January 2013 were selected.  RESULTS: A total of 398 citations were identified; 12 studies accomplished the inclusion criteria. Six referred to PROs and treatment costs; 4 analyzed satisfaction with disease-modifying therapies (DMTs) and 2 assessed preferences for treatment attributes. An increased adherence and persistence on DMTs was associated to higher pharmacy costs and to better clinical outcomes [lower relapse risk (OR=0.71 CI 95%, 0.59-0.85); decreased MS hospitalizations (OR=0.63, CI 95%, 0.47 – 0.83)] leading to a cost reduction of up to 22% patient/year. DMT adherent patients had a significantly lower rate of severe relapses (12.5% vs. 19.5%; p=0.0200), lower MS-related or all-causes medical (7.6% vs. 12.5%; p=0.0447 and 11.2% vs. 20.0%; p=0.0027) and emergency visits (8.9% vs. 15.0%; p=0.0215 and 34.6% vs. 43.5%; p=0.0305) than non-adherent. MS-related and all-cause inpatient costs (354.77±2.485.03 vs. 853.13±3,635.48; p=0.0270 and 648.71±3,753.74 vs. 62.51±265.23; p=0.0018) as well as emergency visit costs (46.46±255.94 vs. 1,740.88±6,127.27; p=0.0076 and 147.82±430.79 vs. 242.42±592.96; p=0.0044) were significantly lower in adherent patients. Self-injection [Visual Analogue Scale (VAS) mean 6.9; range 0-10] render higher treatment satisfaction. Slower disability progression (efficacy) was the most preferred attribute (p<0,001). Newly developed electronic devices that allow adjusting injection settings as well as adherence objective monitoring appeal more to patients (VAS mean 7.7; range 0-10) than more traditional methods of administration. CONCLUSIONS: MS studies assessing adherence and costs are scarce. Treatments and devices better tailored to patients’ needs improve adherence, enhance clinical outcomes and procure a reduction on MS costs.