Abstract
The American Academy of Neurology (AAN) recently chartered the Choosing Wisely Working Group to identify 5 recommendations for improving value and reducing waste in neurologic care. One of these recommendations was “Do not prescribe interferon-β or glatiramer acetate to patients with disability from progressive, nonrelapsing forms of multiple sclerosis.” Release of this recommendation precipitated an emotional, strongly negative response from many multiple sclerosis (MS) neurologists, and this discontent was enhanced when it was recognized that an administrative oversight prevented this recommendation from being vetted by the MS Section of the AAN before it was released. It has been argued that the evidence used to support this recommendation is fundamentally flawed and suggested that the resultant absence of evidence should not preclude treatment of the individual patient with MS.1
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