Abstract Background Due to the preventive nature of disease-modifying therapies for multiple sclerosis, treatment success particularly depends on adherence to therapeutic regimens and patients’ perception of treatment efficacy. The latter is strongly influenced by the confidence in the involved health care professionals and the relationship to the treating physician. Methods In this report, we considered physicians’ and patients’ evaluation of satisfaction with interferon beta-1b treatment efficacy for assessing the congruence in ratings. Data were queried in a study conducted between 2009 and 2013. Results After 6 months of therapy, > 80 % of the patients and physicians ( N = 445) showed high degrees of satisfaction regarding interferon beta-1b treatment, with only few physicians and patients (≤2.0 %) rating “not satisfied”. The proportion of patients rating with the same category as their physicians was similar after 6 months (47 % congruence) and at the 24 months/study end visit (49 %). Discrepancies between ratings were observed with respect to study end: for patients with premature study end, more patients and physicians rated being not satisfied with the therapy, accompanied by a considerably lower congruence of 33 % compared to 54 % for patients receiving the therapy for at least 2 years and completing the study regularly. Conclusions Regular communication between physicians and patients about their perception of therapy might improve alignment of treatment evaluation and could result in increased therapy persistence. In addition, patients’ willingness to perform a long-term therapy − even in the absence of disease symptoms − might be promoted by repeated exchange between health care providers and patients with regard to realistic treatment expectations. Trial registration ClinicalTrials.gov NCT00902135 (registered May 13, 2009).