The article discusses the most unfavorable course of multiple sclerosis — the secondary progressive form. In the course of the study, conducted by a questionnaire survey of patients with secondary progressive multiple sclerosis and specialists from multiple sclerosis centers from 15 regions of Russia, medical, labor and other characteristics of patients, their problems and needs, subjective attitude to the effectiveness of therapy and rehabilitation were clarified. The main, according to doctors, defects in the organization of medical care for patients with secondary progressive multiple sclerosis have been identified. In conclusion, it was concluded that there is a significant variability in the social status and living conditions of patients with secondary progressive multiple sclerosis. The authors consider the registration in the Russian Federation of highly effective drugs for the treatment of patients with secondary progressive multiple sclerosis to be one of the most important measures.