National Institute for Health and Clinical Excellence (NICE)
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First oral therapy for MS approved by NICE

Patients with relapsing remitting multiple sclerosis can now be offered a pill that helps reduce the number of relapses, says NICE.

Multiple sclerosis is a condition where white blood cells attack the coating of nerve cells which help messages from the brain travel to the rest of the body.

The most common form of this condition is relapsing-remitting multiple sclerosis (RRMS), where symptoms come and go, and periods of good health are followed by a sudden onset of symptoms.

Around 27,500 people in England and Wales are thought to have RRMS, which is normally treated through injection.

Fingolimod (Gilenya) is the first pill-based medicine for the treatment of RRMS, and works by preventing white blood cells from attacking nerve cells in the brain and spinal cord.

In final guidance, NICE says the drug can be used for adults with RRMS who have an unchanged or increased relapse rate, or ongoing severe relapses in comparison with the previous year, despite taking beta interferons.

NICE also says that people with RRMS who currently receive fingolimod, but whose disease does not meet these criteria, should be able to continue receiving the drug until they and their doctors decide it is appropriate to stop.

NICE says its recommendation for the use of fingolimod only applies if the drug manufacturer provides the drug at a confidential discounted price.

This has been proposed in the manufacturer's patient access scheme. These are schemes that pharmaceutical companies suggest as part of the development of a NICE technology appraisal in order to reduce the cost to the NHS so that the drugs become cost effective.

Professor Carole Longson, Director of the Health Technology Evaluation Centre at NICE, said: “We are pleased to recommend fingolimod as a treatment option for the specific patient population for whom it has been demonstrated to be cost effective, providing Novartis applies its proposed discount.

“Multiple sclerosis can be a disabling condition and so we hope that this novel treatment will help to reduce relapses for these people.”

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