New MS drug made available on NHS but nurse calls for more

The likely green light for future routine use of ocrelizumab (Ocrevus) comes in final draft guidance, published today by the National Institute for Health and Care Excellence, after healthcare professionals campaigned for the move last year.

“It definitely gives hope for people that have progressive MS”

Joanna Smith

It will mean that, once the final guidance comes out next month, ocrelizumab will be the first treatment that can modify or change the course of the disease for those with the primary progressive form of MS, to be offered on the NHS.

MS specialist nurse, Joanna Smith, who supported the campaign, welcomed the move but told Nursing Times that “further treatments” were needed to help those with this particular form of the condition.

Ms Smith, who works at the Richmond Community Neuro-Rehab Team, said: “I think further treatments are needed for progressive MS – because this is the first one.

“But I think it definitely gives hope for people that have progressive MS,” she said, highlighting that, currently, the other drugs available were for relapsing-remitting MS.

“I think it will make people feel that they’re listened to and that there is at least one treatment option and hopefully more to come in the future,” she said. “Obviously it’s not for everybody but it’s really exciting to hear.”

The drug was initially rejected by NICE last September, because it was considered too expensive for the benefits it could provide.

Following this rejection, the MS Society ran a campaign which called on NICE, NHS England and the drug’s manufacturer Roche, to reach a deal to provide the treatment on the health service.

“Today the NHS is making a significant advance in the care of people living with multiple sclerosis”

Simon Stevens

The campaign included a 21,000 strong petition that was backed by healthcare professionals, cross-party politicians and celebrities.

Eight months on, NHS England has today announced that a deal has now been struck.

It is estimated that 10,000 to 15,000 people have primary progressive MS in the UK, of whom 2,700 adults could be eligible for ocrelizumab.

It is licensed for early primary progressive MS, which is defined by how long someone has lived with MS symptoms, their level of disability, and MRI scans showing inflammatory activity, noted the MS Society.

Director of external affairs at the MS Society, Genevieve Edwards, described the new deal as a “landmark moment” and an “incredible victory” for those that helped its campaign.

“We now want to see everyone who could benefit from ocrelizumab being able to access it, with increased support for MS services to make sure this happens,” she said.

In previous clinical trials, patients saw an average drop of 25% in the risk of their disability getting worse, according to the MS Society. The treatment could also delay the need for a wheelchair by seven years, it added.

Ms Edwards said: “Right now, however there isn’t enough evidence to show ocrelizumab can work for everyone, and we know the restrictions will be a massive blow for those who still don’t have any options.”

“We’re driving research to find more and better treatments and calling for drug trials to more fully address the needs of everyone with MS, until the day we are able to stop it in its tracks,” she said.

According to NHS England, it secured the deal with Roche after “tough negotiations”. As a result of the deal, it noted that the cost-effectiveness estimates for ocrelizumab were now in the range that NICE considered an acceptable use of NHS resources.

NHS England chief executive Simon Stevens said: “Today the NHS is making a significant advance in the care of people living with multiple sclerosis.

simon stevens confed 1

Simon Stevens

Source: Neil O’Connor

Simon Stevens

“This latest innovative deal is further proof that companies willing to work flexibly with the NHS can secure a constructive partnership that benefits both patients and taxpayers,” he said.

NHS England highlighted that having more direct involvement with industry and working closely with NICE meant it could find deals that worked for patients and taxpayers.

Under previous arrangements, it would have been down to industry proposing a price that NICE would either say yes or no to, it noted.

Ocrelizumab will be given as an infusion during an outpatient appointment once every six months and costs around £19,000 per patient per year at full price.

However, the details of the commercial arrangement struck by NHS England and Roche to make the drug available are confidential.

NHS England stated that giving patients access to world class, cutting edge drugs and therapies was a key part of the NHS Long Term Plan.