Cuts to MS treatment options being considered because of drug costs

It cannot be right, it just can’t be. People newly diagnosed with multiple sclerosis, or wishing to change treatments, are facing being denied five approved disease modifying therapies.

And the reason? All five have been judged to be not cost-effective enough for use by the UK’s National Health Service (NHS), in those situations. However, anyone who is currently on one of these treatments now would still be able to take them.

The proposal comes as a preliminary recommendation from the National Institute for Health and Care Excellence (NICE), and affects the NHS in England and Wales. NICE exists to provide national guidance and advice to improve health and social care.

A consultation period ends this Wednesday, January 24, so there is no time to lose if you want to make your views known. You can do so by following this link. Comments are welcome from patients, doctors, caregivers and others.

NICE is to meet again on March 6 to review comments received and discussions it has had with the drugs’ manufacturers. It will make final recommendations after that.

treatment optionsSo far, the draft decision means that Extavia (interferon beta-1b) will continue to be available for new patients. But other beta interferons, and glatiramer acetate, will only be provided for people who are already taking them.

The treatment options that NICE proposes to make the unavailable, to people who are newly diagnosed or want to change treatment, are:

         Avonex (interferon beta-1a)

         Betaferon (interferon beta-1b)

         Copaxone (glatiramer acetate)

         Plegridy (peginterferon beta-1a)

         Rebif (interferon beta-1a)

NICE says its draft recommendation is based on its belief that all these treatments have a similar clinical effect, but only Extavia is cost-effective.

Treatment options: A backward step

MS organisations have, understandably, been quick to condemn the proposal.

MS Society director of external affairs Genevieve Edwards says the society does not want to see patient choice limited in this way.

She said: “While people with MS already receiving these treatments can be assured they won’t have to come off them, we’re worried about what this proposal means for the future of patient choice. We have made so much progress on treatment options for people with MS, and it would be a significant step backwards if people with MS were now left with less choice and potentially no effective option.

“We want the companies who make these drugs to keep negotiating and come to a deal with NICE and NHS England so patients don’t lose out. Everyone with MS should be able to get fair and equal access to the right treatments at the right time.”

The MS Trust said it was disappointed with NICE’s preliminary decision.

“We do not believe that NICE’s recommendations are in the best interests of people with MS or the National Health Service,” it said in a news release.

“We strongly believe that all current treatments should remain available as treatment options for all eligible patients.”

The MS Trust said the preliminary recommendations fail to address several issues, including:

         how healthcare professionals administer different drugs;

         how each drug matches the different lifestyles of people with MS; and

         how the side effects of each drug can affect patients differently.

“We are fully committed to supporting people with MS to get the best and most appropriate treatment for them,” the MS Trust said.

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* * * * * is the personal website of Ian Franks, a freelance medical writer and editor for various health information sites. He enjoyed a successful career as a journalist, from reporter to editor in the print media. He gained a Journalist of the Year award in his native UK. Ian received a diagnosis of MS in 2002 and now lives in the south of Spain. He uses a wheelchair and advocates on mobility and accessibility issues.

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