OBJECTIVES: To describe the changing landscape of disease modifying therapy (DMT) prescribing among treatment-naïve patients diagnosed with multiple sclerosis (MS) since the recent introduction of oral options. METHODS: Adult (≥18 years) patients with a diagnosis of MS (ICD-9-CM 340) and ≥2 claims for an oral (fingolimod, teriflunomide, dimethyl fumarate) or non-oral (interferon beta-1a, interferon beta-1b, glatiramer acetate, natalizumab) DMT between March 29, 2013 and February 1, 2014 (first prescription=index date) were identified in the Truven Health MarketScan® databases. Patients had ≥15 months of continuous enrollment (12 months pre- and 3 months post-index) with no DMT pre-index. Demographic and clinical characteristics were measured and compared at index and in the 12 month baseline period, respectively. RESULTS: A total of 3,221 patients (mean age 46.5 years [SD=11.6]; 75.2% female) met all study criteria. Approximately half (49.3%) of patients were prescribed an oral DMT. The most commonly prescribed DMT was dimethyl fumarate (38.2%), followed by glatiramer acetate (23.1%), natalizumab (8.9%) and intra-muscular interferon beta-1a (8.4%). Patients initiating treatment with an oral DMT were older (47.5 years [SD=10.9] vs. 45.5 years [SD=11.6]) and a higher proportion were prescribed symptomatic medications including antidepressants (39.1% vs. 32.2%), muscle relaxants (33.5% vs. 27.0%) and antispasmodics (24.7% vs. 15.9%) than those initiating with a non-oral DMT (all p<0.001). A higher proportion of non-oral initiators had an MS-related inpatient admission (8.8% vs. 5.7%, p<0.001), were prescribed oral corticosteroids (38.2% vs. 33.3%) and had a diagnosis of non-neuropathic pain (52.1% vs. 47.8%), headache (30.2% vs. 26.3%) and neuropathic pain (18.6% vs. 14.7%) than oral initiators (all p<0.05). CONCLUSIONS: This study showed that despite being widely available for only a short period of time relative to injected and infused DMTs, oral formulations have captured half the market among treatment-naïve MS patients. Channeling could be influenced by age, concomitant medication use and co-morbid disease.