News - February 2007
Open Door - February 2007 page 3
- Scottish Medicines Consortium finds Tysabri not cost effective
- Obligation to provide disease modifying drugs
- Netherlands bans private stem cell therapy
1. Scottish Medicines Consortium finds Tysabri not cost effective
In December, the Scottish Medicines Consortium (SMC) announced that it had decided not to make Tysabri (nataluzimab) available on the NHS in Scotland.
Tysabri has been licensed in the UK since June 2006 as a treatment for rapidly evolving severe relapsing/remitting MS and for people with active relapsing/ remitting MS who have failed to respond to treatment with beta interferon.
SMC decisions are based on cost-effectiveness, using the cost per quality adjusted life year (QALY). The QALY is a health economic formula which tries to determine the value of a treatment to a person's life, not the actual cost of providing the drug. The cut-off point used by the SMC is not clear, although it has been estimated between £20-30,000 per QALY.
Chris Jones, MS Trust Chief Executive, commented: "Accountancy has trumped clinical evidence with this decision. For a well defined group of people with MS, this drug is highly effective, leading to 60-70% reductions in relapses. Only an economist could make that sound expensive. Clinicians will be prevented from prescribing an effective licensed treatment to people in need. We urge people with MS to continue fighting for Tysabri on an individual basis. We trust that the National Institute for Health and Clinical Excellence (NICE), on behalf of people with MS in England and Wales, will not to be so short sighted when it makes a decision on Tysabri in early 2007."
Read or download the MS Trust's Tysabri factsheet
2. Obligation to provide disease modifying drugs
In November the Department of Health contacted Strategic Health Authorities in England to remind them of their obligation to provide disease modifying drugs for MS to people who meet the prescription criteria.
The drugs - Avonex, Betaferon, Copaxone and Rebif - are provided under the Risk-sharing Scheme. A proportion of people receiving the drugs are being monitored for the long-term cost effectiveness of the products.
The briefing note reminds PCTs and Hospital Trusts that, under the NHS Act 1977, the provision of drugs to people who meet the prescription criteria is an obligation not an option and is not dependent on their being in the monitored group.
Also in November, the Channel 4 Dispatches programme reported on three conditions, including MS, in which people are being denied drugs recommended by NICE. In all three cases covered, the protests of those personally involved resulted in finance being released after initial negative decisions, leading to presenter Jon Snow's closing exhortation: "Don't take no for an answer!"
3. Netherlands bans private stem cell therapy
On 1 January, the Dutch government banned commercial stem cell clinics, such as PMC in Rotterdam, from offering unproven treatments. The ministry of health said that it was concerned that "centres in the Netherlands are offering this form of treatment as if it is common practice while in fact it is in the early stages of development." Treatment at PMC was suspended in October by the Dutch Healthcare Inspectorate following concerns about the source and safety of the cells used.
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