Multiple Sclerosis

Lord Walton of Detchant Excerpts

Thursday 13th October 2011 Lords Chamber

Asked By

[Lord Walton of Detchant]

To ask Her Majesty’s Government what action they are taking to improve the United Kingdom’s international standing in relation to patient access to new treatments for multiple sclerosis.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

My Lords, a number of treatments for multiple sclerosis are available to UK patients, supported by the multiple sclerosis risk sharing scheme, National Institute for Health and Clinical Excellence guidance and Scottish Medicines Consortium advice. Our priority is to ensure that patients have access to new and effective treatments. NICE’s forthcoming review of its clinical guideline on MS will bring together up-to-date advice on the best treatments for patients, as part of the overall package of care.

[Lord Walton of Detchant]

My Lords, I thank the noble Earl the Minister for that reply. It is true that the prognosis for many patients with multiple sclerosis has been transformed by the use of these immunosuppressive agents since interferons were introduced. Is he aware that recently a new and effective remedy called fingolimod, which is available by oral administration instead of injection, has been introduced? It has been licensed but has been rejected by NICE for the moment purely on cost grounds. At the moment, evidence suggests that about 60 per cent of patients with this condition in the United States, 30 per cent in most of Europe and only 17 per cent in the UK are receiving this type of medication. Is it therefore not likely that this is the result of restraints on prescribing largely on financial grounds?

[Earl Howe]

The noble Lord is quite right about fingolimod. Since the publication of NICE’s draft guidance, the manufacturer has proposed a patient access scheme for the drug, and the department has agreed that this can be considered as part of NICE’s appraisal. The noble Lord raises a very interesting point about cost. Professor Mike Richards’s report, which came out last year and looked at the extent and causes of international variations in drug usage, outlined a number of potential explanations for the relatively low uptake of some treatments. In the case of MS, one of the reasons identified was caution among some neurologists about the benefits of particular treatments, but also tighter clinical guidelines on the use of MS treatments in the UK compared with some other countries. It is important to stress that in treating MS, medicines form only part of an overall package of care, which of course can consist of access to neurology services and specialist MS nurses.