National Institute for Health and Clinical Excellence (NICE)
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Calls to improve uptake of NICE-approved treatments for MS

Less than five per cent of people with multiple sclerosis (MS) who are eligible to receive NICE-approved drugs are being offered them, according to new research.

MS is a neurological condition that affects around 100,000 people in the UK. Symptoms include fatigue, difficulties with speaking, and problems with memory and vision. In certain cases the condition can lead to severe and permanent disability.

There is currently no cure for MS, with treatment usually carried out using disease modifying treatments (DMTs). These are used to treat rapidly relapsing MS, which is the most common form of the condition, characterised by periods when symptoms worsen and then improve.

The research, published in a report by the MS Society, has found that 60 per cent of people with relapsing forms of MS are currently going without any form of DMT treatment. Poland and Romania are the only countries in Europe which fare worse in this area.

The report also revealed that across England, the NHS has been slow in adopting clinical and cost-effective new MS medicines approved by NICE.

It found that a mere 5 in 100 of people with MS that NICE says are eligible for natalizumab (Tysabri) are currently taking the drug, and that only 1 in 100 eligible people with MS are taking fingolimod (Gilenya). This is despite the fact that NICE guidance on the drugs has been available since 2007 and 2012 respectively.

The report recommends that local health authorities should abide with the 90-day timescale, set by the Department of Health, for which new Technology Appraisals approved by NICE should be incorporated into local formularies.

It also quotes the NHS Constitution which states that patients have the right to drugs and treatments recommended by NICE for use in the NHS, if their doctor says they are clinically appropriate.

NICE has produced a good practice guide to help with updating and developing local formularies, which can help to reduce variation in prescribing, and ensure patients have access to new clinically and cost-effective drugs.

The guide recommends that medicines recommended by NICE should be included into the local formulary automatically, where clinically appropriate and relevant to the services by the organisation. This process should take place within three calendar months.

NICE says that this is to support compliance with the NHS Constitution, ensuring that new clinical and cost-effective medicines are available for clinicians to prescribe, should they choose to.

Nick Rijke, Director for Policy & Research at the MS Society, said: Our survey findings worryingly suggest that the likelihood of someone receiving a life changing treatment or service is often based on luck - like where they live or how helpful their healthcare professional is - rather than their genuine clinical need.

"When it comes to MS drug prescription rates, the UK ranks 25th out of 27 European countries. Given the relative wealth of the UK this is simply unacceptable."

Professor Gillian Leng, Deputy Chief Executive of NICE, said: "The NHS has a duty to ensure the rapid uptake of innovative, effective medicines and treatments recommended by NICE. This mandate has been recently legislated in the NHS Constitution for England."

Further recommendations outlined in the report include for NICE to develop a quality standard on MS to help commissioners, for authorities to provide every person with MS with personalised care, and for NHS Commissioning Board Local Area Teams to publish prescribing rates for MS treatments.

 

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