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Multiple Sclerosis Centers of Excellence


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MSCOE Newsletter Announcement

MS Veteran Newsletter

Discusses symptom management, medications, and living well with MS. Check out our latest issue!

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Get Out and Play

Get Out & Play

Adaptive sports can help keep you in the game. No matter your skill level, there is a sport for you.

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People at CMSC Annual Meeting

MSCoE at CMSC Annual Meeting

Learn about presentations, platforms, and posters with VA staff at the MS Centers Annual Meeting!

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Multiple Sclerosis Centers of Excellence

The Multiple Sclerosis Centers of Excellence are dedicated to furthering our understanding of multiple sclerosis (MS), its impact on Veterans, and effective treatments to help manage MS symptoms. By partnering with Veterans, caregivers, health care providers, and other service organizations we hope to minimize impairment and maximize quality of life for Veterans with MS.

MSCoE Network


VA MS Publications

map of USMSCoE Network

MSCoE East and West have developed a national network of MS Regional Programs and MS Support Programs within the VA.

Given the size of the population of Veterans with MS seeking treatment in VA and their distribution across the country, it is feasible to provide access to high quality subspecialty care through a hub and spoke network with designated MS Regional Programs supporting local facilities.

Each Veterans Integrated Service Network (VISN) will have at least one MS Regional Program that will serve as a source for MS specialty consultation and education. The primary care for individuals with MS will occur at their local VA medical facilities. MS Support Programs will collaborate with local MS Regional Programs. The MS Care Liaison at VA medical facilities with an MS Support Program will assist with coordination and referrals to the MS Regional Program as needed.

white figure talking through microphoneAnnouncements

May 10, 2018

Due to high levels of demand for GSK’s Shingrix vaccine, providers should anticipate ordering limits and intermittent shipping delays for Shingrix between now and the end of June 2018, whether vaccine is ordered directly from GSK or through wholesalers and distributors. GSK is currently working to make more doses available in the near term for the US market in order to meet the demand for this vaccine.

May 2, 2018

The 8th International Symposium on Gait and Balance is taking place September 15, 2018 in Portland, OR. This conference focuses on the impact and implementation of exercise in MS. The morning focuses on the immunologic, disease modifying, cardiovascular, musculoskeletal, and psychological effects of exercise in MS. The afternoon focuses on clinical applications of exercise in MS and includes presentations on optimizing exercise adherence, high intensity exercise, and exercise prescription. The daytime presentations will be followed by a poster reception, offering the opportunity to discuss new research findings, as well as to network and exchange ideas in a more relaxed social setting.Please send abstracts on topics related to gait and balance in MS to Gail Widener at by June 15, 2018.

April 5, 2018

There is now a generic glatiramer 40 mg TIW product available from Mylan. There are some facilities and Consolidated Mail Outpatient Pharmacies (CMOPs) which have begun a therapeutic interchange with this product from the branded Copaxone product. The National Pharmacy Benefits Management Services (PBM) is working with facility pharmacies to assist with this change. To decrease the number of potential interchanges a Veteran may have, the PBM and CMOP have agreed to use the Sandoz product for glatiramer 20 mg dose and the Mylan product for glatiramer 40 mg dose.

There are patient and provider letters regarding this therapeutic interchange. They can be found at Clinical Guidance Patient and Provider Letters. The provider letter notes the GATE TRIAL in JAMA Neurol. 2015; 72(12):1433-1441 which should be reviewed. This study was conducted using the Synthon/Mylan product.

Veterans will need to have the corresponding auto injector for the product dispensed. All the auto injectors are available from the CMOP. If you cannot identify which product to order, please contact your pharmacy and they can help you. Facility pharmacies have been provided the ordering information for each injector and have been provided education regarding each product requiring a specific auto injector. Information from the FDA on the approval process for generic drugs may help in understanding the generic approval process. Both generic glatiramer products have product support programs in place.

March 29, 2018

The MS Team at the Madison, WI VA hosted a table for MS Awareness Month. Thank you for all that you do for Veterans in your area and for being a part of the MSCoE Network!

picture of table with MS flyers

March 26, 2018

In November 2017, Zostavax was removed from the VA National Formulary and was replaced with Shingrix. Here is a short summary: (1) Shingrix is more effective than Zostavax in preventing cases of herpes zoster (shingles); (2) Shingrix contains an 'adjuvant', boosting vaccine effectiveness and reactions to the vaccine, while Zostavax does not; (3) Shingrix is NOT a live vaccine, unlike Zostavax, which is live; (4) Shingrix does NOT need to be stored frozen while Zostavax needs to be stored in the freezer; (5) Shingrix is given via an intramuscular injection while Zostavax is given via a subcutaneous injection; and (6) Shingrix is given as a two dose series, with doses spaced 2 to 6 months apart while Zostavax is given as a single dose.

Shingrix is not a live vaccine. The efficacy of Shingrix in MS and those on B-cell depleting therapies (rituximab, ocrelizumab) is not known but may be reduced. When possible, complete the Shingrix series prior to starting immunosuppressive or B-cell depleting therapies in people with MS. The safety of Shingrix in MS is not known. Adverse events with Shingrix are listed in the package insert.

FAQ document from VHA PBM
VHA PBM Criteria for Use

March 3, 2018

There is a voluntary withdrawl of daclizumab (Zinbryta®) from the market.

March 1, 2018

Visit the VA Blog to read Army Veteran Crystal Muscatello's story about living with MS.

January 4, 2018

The National Veterans Wheelchair Games are in Orlando, FL July 30 - August 4, 2018.