OBJECTIVES: This study aims to describe temporal trends and geographic discrepancies on public pharmaceutical expenditures with multiple sclerosis (MS) treatment in Brazil. METHODS: Longitudinal analysis of Brazilian MS pharmacy claims as reported in the Brazilian Ambulatory Information System Database. Analyses were based on aggregate data from the 27 Brazilian states, observed annually for the period 2006–2009. The total MS-related expenditures were segmented by state, drug (Glatiramer 20mg, Betainterferon 22mcg, Betainterferon 44mcg, Betainterferon 30 mcg, and Betainterferon 300mcg), and year. Per capita calculations were also performed using Brazilian 2009 population. RESULTS: MS public expenditures with MS drugs had a significant rising from 30,423,930BRL in 2006 to 214,405,349BRL in 2009, a more than 7-fold increasing. Total investments in MS drugs totaled 629,917,685BRL. Federal funding transfers for the state of Roraima presented the highest growth rate (1,497%) rising from 10,549BRL in 2006 to 157,973BRL in 2009. São Paulo (41,384,039 inhabitants, 1/5 of Brazilian population) was responsible for the higher absolute investment (13,130,526BRL and 88,948,997BRL in 2006 and 2009, respectively) and the higher total expenditure for the period (259,591,564BRL, 1/3 of national expenditures). The lowest spending was observed for states in the North Region – Amapá had any MS claim in the 4-year period and Acre had the lowest value (184,754BRL). Both states had similar projected 2009 population and are located at regions with very similar characteristics (both ethnically and geographically). Betainterferon 44mcg represented the highest expenditures in 2009 and had the highest annual cost per patient (54,288BRL). Conversely, Betainterferon 22mcg was the only drug with decrement in the period, decreasing from 34,774,157BRL in 2007 to 32,304,159BRL in 2009. CONCLUSIONS: Our findings highlighted geographic discrepancies within the Brazilian healthcare system in terms of MS treatment funding even when demographic aspects were considered. Nevertheless a constant increasing in public expenditures was observed across most states.