OBJECTIVES:  Relapsing Remitting Multiple Sclerosis (RRMS) can be treated with a number of injectable disease-modifying therapies (DMTs) collectively known as BRACE therapies. Fingolimod was the first oral DMT licensed for use in RRMS patients. The objective was to determine the incremental cost-effectiveness of switching immediately to Fingolimod compared to continuing on BRACE (Interferon beta 1-b, Interferon beta 1-a, Glatiramer Acetate) therapies in RRMS patients with a history of disease activity on BRACE therapies. METHODS: A cohort based Markov state transition model comprising 11 health states was used to estimate cost-effectiveness. Heath states were defined using Kurtzke Expand Disability Status Scale (EDSS) and mean EDSS status at baseline was set at 2.7 to reflect current disease activity. Population characteristics and treatment costs were obtained for Germany. Disease progression hazard ratios were sourced from FREEDOMS I and II. The length of treatment period prior to switching was user definable with an annual probability of 0% discontinuation for each treatment arm for the duration of treatment prior to switching and 9.3% for the following 10 years. 6 monthly relapse rates were sourced from the PEARL and PANGEA studies. An annual discount of 3% was applied to both costs and effects. RESULTS:  From both payer and societal perspectives, immediately switching to Fingolimod strictly dominates (is less costly and more effective than) a strategy of continuing on BRACE therapies followed by a switch to Fingolimod at any time point. There is a negative relationship between the year of switching to Fingolimod and the resultant Net Monetary Benefit (assuming a WTP threshold of €40,000/QALY). CONCLUSIONS:  From both payer and societal perspectives, it is preferable to switch immediately to Fingolimod than to continue to cycle on BRACE therapies in terms of cost-effectiveness in RRMS patients with a history of disease activity on BRACE therapies.