OBJECTIVES: Fingolimod oral tablets were approved in the United States (US) in September 2010 for the treatment of relapsing remitting multiple sclerosis (RRMS). The objective of this study is to assess the costs associated with Fingolimod treatment for patients diagnosed with RRMS in the US.  METHODS: A large US administrative retrospective claims database was used to identify patients diagnosed with RRMS and were prescribed Fingolimod between January 2010 to December 2012 were included in the study. All patients were ≥ 18 years of age and continuously enrolled in the same health plan for a year. Descriptive statistics and chi-square tests were performed on the data.  RESULTS: There were a total of 28,477 patients that met the study inclusion criteria. Patients on average were charged $5270.93 ± 2760.33 for their treatment with Fingolimod during the study period. However, the allowed amount by the health plan was $4624.41 ± 2070.65 and the actual paid amount was $4529.98 ± 2074.58. On average, patient’s deductible was $13.64 ± 186.88 and patient co-payment was $86.33 ± 316.10. For patients whose prescription was on their health plans formulary paid on average higher costs compared to patients who were not (paid amount $4679 vs $4317). Even though most of the patients were females, but they had overall lower costs compared to males (amount charged $4513 vs $4582, p>0.05; co-payment $79 vs $106, p<0.05). Patients who received treatment in the Midwest region of the USA had a higher costs compared to east, west and south regions (paid amount $4618 vs $4608 vs $4370 vs $4405).  CONCLUSIONS: The cost of Fingolimod treatment for RRMS patients is higher and costing the health plan around $3552 for 3 months. The cost of the drug treatment was higher in southern of the USA and males were paying more in general.