Can't fill your Kesimpta prescription? Here are proven alternative MS treatments, how they compare, and what to discuss with your neurologist.
If you've been prescribed Kesimpta (Ofatumumab) for relapsing multiple sclerosis and you're unable to fill your prescription — whether because of insurance denials, specialty pharmacy delays, or cost barriers — you're not alone. And you have options.
Gaps in MS treatment can be risky. The disease can remain active even when you feel fine, and missing treatments may allow new relapses or disease progression. That's why it's important to work with your neurologist to find an alternative that keeps your MS under control while you sort out access to Kesimpta — or to find a long-term replacement if Kesimpta isn't going to work for your situation.
This guide covers what Kesimpta is, how it works, and the most commonly prescribed alternatives your doctor may consider.
Kesimpta is a biologic medication made by Novartis. It's FDA-approved for treating relapsing forms of multiple sclerosis in adults, including clinically isolated syndrome (CIS), relapsing-remitting MS (RRMS), and active secondary progressive MS.
The generic name is Ofatumumab. It comes as a 20 mg prefilled Sensoready auto-injector pen or prefilled syringe, self-administered as a subcutaneous injection once monthly (after an initial loading phase of injections at weeks 0, 1, and 2).
Kesimpta is a fully human monoclonal antibody that targets CD20, a protein found on the surface of B lymphocytes (a type of white blood cell). By binding to CD20, Kesimpta triggers the destruction of these B cells through two mechanisms: complement-dependent cytotoxicity and antibody-dependent cell-mediated cytotoxicity.
B cells play a key role in the autoimmune processes that drive MS. They can activate T cells, produce inflammatory cytokines, and act as antigen-presenting cells. By depleting B cells, Kesimpta reduces the immune system's attacks on the myelin sheath — the protective covering of nerve fibers in the brain and spinal cord.
In clinical trials (ASCLEPIOS I and II), Kesimpta reduced annualized relapse rates by 51% to 58% and slowed confirmed disability progression by 32% to 34% compared to Aubagio (Teriflunomide).
If you can't access Kesimpta, there are several other FDA-approved disease-modifying therapies (DMTs) for relapsing MS. Here are the most relevant alternatives, organized by how closely they relate to Kesimpta's mechanism of action.
Drug class: Anti-CD20 monoclonal antibody
How it's given: Intravenous (IV) infusion every 6 months
FDA-approved for: Relapsing MS and primary progressive MS (PPMS)
Ocrevus is the closest alternative to Kesimpta. It works by the same mechanism — targeting CD20 and depleting B cells — but it's administered as an IV infusion in a healthcare setting rather than a self-injection at home. Infusions take several hours and are given every six months after an initial loading dose.
Key consideration: If you liked the convenience of Kesimpta's at-home self-injection, switching to Ocrevus means regular visits to an infusion center. However, the every-6-months dosing schedule is convenient for some patients. Ocrevus is also the only anti-CD20 therapy approved for primary progressive MS.
Drug class: Anti-integrin monoclonal antibody
How it's given: IV infusion every 4 weeks (or subcutaneous injection every 4 weeks in some regions)
FDA-approved for: Relapsing forms of MS
Tysabri works differently from Kesimpta. Instead of depleting B cells, it blocks a molecule called alpha-4 integrin, preventing immune cells from crossing the blood-brain barrier and entering the central nervous system. It's considered a highly effective MS therapy.
Key consideration: Tysabri carries a risk of progressive multifocal leukoencephalopathy (PML), particularly in patients who test positive for the JC virus antibody. Regular monitoring is required. It's typically reserved for patients who haven't responded adequately to other therapies or who have highly active disease.
Drug class: Pyrimidine synthesis inhibitor
How it's given: Oral tablet, once daily
FDA-approved for: Relapsing forms of MS
Aubagio is a once-daily oral medication that works by reducing the number of activated lymphocytes in the central nervous system. It's generally considered a moderate-efficacy DMT compared to high-efficacy options like Kesimpta or Ocrevus.
Key consideration: Aubagio is much easier to access and more affordable than Kesimpta — it's a simple daily pill with a generic available in some markets. However, it's less effective at reducing relapses (Kesimpta outperformed Aubagio by 51-58% in clinical trials). It may be an appropriate bridge therapy while you work on accessing Kesimpta.
Drug class: Purine antimetabolite / selective immunosuppressant
How it's given: Oral tablets in short courses over 2 years
FDA-approved for: Relapsing forms of MS
Mavenclad is unique in that it's an oral MS therapy given in short courses — typically a few days per month for 2 months in year 1, repeated in year 2 — with no treatment needed in years 3 and 4. It works by selectively reducing certain lymphocytes involved in the MS disease process.
Key consideration: The short treatment courses and long-lasting effect make Mavenclad appealing for patients who want minimal ongoing treatment. However, it's generally reserved for patients with highly active disease who have had an inadequate response to, or cannot tolerate, other therapies.
Switching MS treatments is a decision that should always be made with your neurologist. Factors to consider include:
For more on finding Kesimpta specifically, see our guide on how to find Kesimpta in stock near you.
Not being able to fill your Kesimpta prescription is stressful, especially when you know how important consistent MS treatment is. But you're not without options. Ocrevus, Tysabri, Aubagio, and Mavenclad are all proven MS therapies that your neurologist can consider as alternatives.
The most important thing is to avoid treatment gaps. Talk to your neurologist as soon as you know there's an access problem, and explore both short-term bridge options and longer-term alternatives. And if you haven't already, use Medfinder to check Kesimpta availability — you might find that the access issue is more solvable than you think.
For information on the cost of Kesimpta and ways to save, read our guide on coupons, discounts, and patient assistance programs.
You focus on staying healthy. We'll handle the rest.
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