NICE guidance on therapies for multiple sclerosis

Fears that no-deal Brexit could threaten medicine supplies.

The National Institute for Health and Care Excellence (NICE) has issued its Final Appraisal Determination (FAD) recommending the use of four out of six disease-modifying therapies (DMTs) in relapsing-remitting multiple sclerosis. Rebif® (interferon β-1a), Avonex®  (interferon β-1a), Extavia® (Interferon β-1b) and Copaxone® (glatiramer acetate) have been recommended, within their marketing authorisations, as options for treating relapsing-remitting multiple sclerosis in the NHS provided the companies provide the drugs with the discounts agreed in the patient access schemes.

NICE does not recommend Betaferon® (interferon beta-1b), concluding that it would not be a good use of NHS resources. NICE has also stated it is not in a position to recommend pegylated interferon β-1a (Plegridy®) and that there will be a separate single technology appraisal for this drug.

These recommendations are not intended to affect treatment with a beta interferon or glatiramer acetate that was started in the NHS before this guidance was published.

The National Institute for Health and Care Excellence (NICE) have been appraising the clinical and cost-effectiveness of beta interferons (interferon β-1a (Avonex®, Rebif®), Pegylated interferon β-1a (Plegridy®), and interferon β-1b (Betaferon®/Extavia®)) and glatiramer acetate (Copaxone®) in multiple sclerosis, against best supportive care, in the context of a multiple technology appraisal.

The recent FAD follows a preliminary decision in December 2017 to recommend only Extavia® (interferon beta 1b) as an option for treating multiple sclerosis. Since then, Merck continued to work with NICE to ensure that Rebif® remained an option for relapsing-remitting MS patients.

Belinda Byrne, Medical Director, Merck UK & Ireland, said: “Merck is committed to patients’ unmet needs and we are delighted that Rebif® continues to be a treatment option for people with multiple sclerosis. We welcome NICE’s recognition of the value that Rebif brings to patients and that access to these products is secure for patients for the future.”