OBJECTIVES:  Disease progression in multiple sclerosis (MS) can have a substantial impact on healthcare resource use and relapse rates. In turn, therapy persistence might be able to improve disease outcomes. Therefore, this study compared relapse rates and MS-related healthcare resource use of patients persistent on injectable platform disease modifying therapies (DMTs) to non-persistent patients over a two-year period in Germany. METHODS:  A retrospective claims database analysis was performed identifying adult MS patients who initiated treatment (index date) with a first-line injectable DMT including interferon beta-1a, interferon beta-1b, and glatiramer acetate between January 2010 and December 2012. Continuous enrolment within the health insurance during 12 months pre- and 24 months post-index date was required. Patients were stratified based on their persistence (defined as no gaps of ≥60 days between prescriptions within the 24 month post-index period) to the index DMT. Relapse rates and MS-related healthcare resource use were compared between persistent and non-persistent patients. Multivariate analyses were used to evaluate the impact of persistence on MS-related outcomes adjusted for age, gender, Deyo-Charlson Comorbidity Index, pre-index MS-related hospitalization, and corticosteroid prescription fill. RESULTS:  In total, 62% of the identified 1,413 patients were persistent. The mean age was approximately 40 years with two-thirds being female in both cohorts. The adjusted risk of relapse was higher in the non-persistent cohort than the persistent cohort (HR = 1.38, 95%CI [1.12, 1.70], P = 0.003). The proportion of non-persistent patients hospitalized due to MS was 85% greater than in persistent patientst (22% vs. 12%, P < 0.001). The adjusted odds ratio (OR) for any MS-related inpatient stay was highly significant (non-persistent vs. persistent OR = 2.15, 95%CI [1.60, 2.90], P < 0.001). CONCLUSIONS:  In a real-world setting, injectable DMT persistence over a two-year period is associated with lower relapse rates and MS-related inpatient stays in Germany.