Ocrevus Zunovo implementation, feasibility, acceptability, patient satisfaction, treatment persistence, and impact on MS disease outcomes will be analyzed in this mixed methods study. This study will incorporate clinical data and questionnaire results from MS patients who take Ocrevus Zunovo as well as qualitative interviews with MS patients, family members, and other individuals involved in Ocrevus Zunovo treatment. The purpose of this study is to synthesize implementation strategies that improve patient access to high-efficacy MS therapies in real-world settings.

Patients with MS who are clinically seen at the Northwestern Memorial Hospital system and are eligible for Ocrevus Zunovo (OZ) initiation may enroll in this study. OZ will be administered by the clinical infusion center.

We will enroll 50 OZ-treated MS patients over the course of 15-18 months, at approximately 4 patients per month. Participants will each be surveyed and followed at three main timepoints: (1) enrollment, as close as possible to the time of first OZ dosing, (2) 6 months of follow up, and (3) 12 months of follow up.

We will also conduct 100 semi-structured interviews, where facilitators and barriers will be recorded by patients, relevant stakeholders in their care and insurance billing, administrators, and clinical staff members.

Inclusion Criteria:

• Age of 18 years or older
• Resident of the USA
• Seen at Northwestern Medicine
• Meets diagnostic criteria (2024) for MS, either RMS or PPMS
• Diagnosis of MS (G35) on file by a neurologist
• Wants to start or restart a DMT for MS
• Willing to be in a 12-month follow up study

Exclusion Criteria:

• Unclear diagnosis of MS
• Incarcerated
• Unable to provide informed consent
• Current participant in an MS or any experimental therapy clinical trial
• Moribund
• Unable to speak a language for which consent processes are available at Northwestern Hospitals
• Currently taking a DMT that has not been washed out (e.g. recent treatment with Cladribine, Natalizumab, sphingosine 1-phosphate inhibitor, implying the last DMT is still actively immunosuppressing the patient)
• Current chemotherapy
• History of stem cell transplant, CAR-T or other chemo-ablative procedures
• Unwilling to complete surveys over the course of the following 12 months
• No access to computer or telephone
• Prior allergic reaction or intolerance to Ocrelizumab IV or SubQ or any monoclonal antibody therapy
• Hypogammaglobulinemia IgG level <500
• Leukopenia <2.0
• Active hepatitis or latent hepatitis B
• Elevated liver enzymes 3 times the upper limit of normal
• Tuberculosis
• Current serious infection, e.g. COVID-19, shingles, active pneumonia, progressive multifocal leukoencephalopathy, etc.
• Currently pregnant, breastfeeding, or a person of childbearing capacity who is sexually active without a documented plan of current contraceptive methods.
• Any other diagnosis or reason deemed to make the participant unfit for participation by the study PI

Patients with MS who take OZ for their treatment are eligible. There must be a signed prescription for OZ for the MS patient. Patients who choose OZ will be offered dosing at Northwestern in the outpatient setting. Patients will be asked to complete assessments on demographic, clinical, and insurance-based factors at baseline, 6-, and 12-month visits. Patients will be invited to complete semi-structured interviews on these factors and their experiences.