Only 40% of people eligible for drugs to combat multiple sclerosis in the UK are actually taking them, says a report from the MS Society.
A survey of more than 10,000 adults with MS showed that many were missing out on the seven licensed medicines approved for use.
The charity said a lack of information and access to specialists was to blame.
It is calling for the government to provide a personalized care plan to every person with MS.
The MS Society’s survey and accompanying report showed that there were differences in access to disease-modifying treatments (DMTs) across the four nations of the UK.
These are medicines that can reduce the frequency and severity of MS attacks, and in some cases can slow the progression of the disabling condition.
Someone living in Northern Ireland with MS was twice as likely to be taking a DMT (68%) than someone with the condition in Wales (30%), for example.
Access to treatment in Scotland and England was only a little higher at 36% and 40%.
In Europe, additional research shows that only Poland and Romania have a smaller proportion of people with MS taking licensed medicines.
Routine assessment
The charity’s report said that being well informed about the medicines available was crucial.
Those who felt they had enough information about medicines were 32% more likely to be taking a DMT, the survey found, and those with access to a specialist MS nurse or neurologist were more than twice as likely to be taking the appropriate drugs.
Northern Ireland is the only place in the UK where most people with MS are routinely invited every six months to see a neurologist or MS nurse for a review.
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