OBJECTIVES: The objective of this study is to assess and compare the health care costs associated with patients diagnosed with relapsing remitting multiple sclerosis (RRMS) and taking Fingolimod capsules or Teriflunomide tablets.  METHODS: A large US administrative retrospective claims database was used to identify patients diagnosed with RRMS and were prescribed Fingolimod or Teriflunomide between January 2010 and 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, chi-square tests and regression analysis were performed on the data and statistical significance level was set a priori at 0.05. RESULTS: There were a total of 3,102 patients on Fingolimod and 114 on Teriflunomide that met the study criteria. Patients on average were charged $5168.66±2371.50 and $3811.13±1377.13 for their treatment (p<0.001). However, the amount allowed (p<0.001) by the health plan was $5013.07±2351.37 and $3705.05±1373.52 and the actual amount paid (p<0.001) was $4905.78±2344.11 and $3630.08±1375.79 for a month supply. On average, patient’s deductible (p=0.748) was $12.12±106.89 and $8.40±55.13 and patient co-payment (p=0.887) was $75.14±239.49 and $78.74±159.46 for Fingolimod and Teriflunomide. The majority of the Fingolimod (54.9%) and Teriflunomide (92.1%) patients were charged anywhere between $50K to $100K and $25K to $50K for their treatment per year. For patients whose prescription was on their health plans formulary ($148.37±12.99 vs $126.88±15.62) on average charged per day lower compared to patients on non-formulary status ($158.22±25.40 vs $125.98±39.61). The regression analysis shows that patients receiving drug supply ≤30 days, having mental health issues, individual coverage, patient’s <65 years of age and patients receiving Fingolimod were more likely (p<0.05) to have higher charges.  CONCLUSIONS: The cost of Fingolimod treatment for RRMS patients is higher than Teriflunomide.