Fingolimod (Gilenya®) is recommended as an option for use within NHS Wales for use as a single disease modifying therapy in highly active relapsing remitting multiple sclerosis for the following adult patient group: - patients with rapidly evolving severe relapsing remitting multiple sclerosis defined by 2 or more disabling relapses in one year, and with 1 or more gadolinium enhancing lesions on brain MRI or a significant increase in T2 lesion load as compared to a previous recent MRI. This recommendation applies only in circumstances where the approved Patient Access Scheme (PAS) is utilised or where the list/contract price is equivalent or lower than the PAS price.