Technical / NICE: New multiple sclerosis treatment

The recommendation covers people with active relapsing-remitting multiple sclerosis previously treated with disease-modifying therapy and those with rapidly evolving severe relapsing-remitting multiple sclerosis for whom alemtuzumab is contra-indicated or otherwise unsuitable.

Multiple sclerosis is a chronic, disabling neurological disease. It occurs when the body’s immune system destroys myelin, a protective sheath around nerve cells in the brain and spinal cord. Around 86,200 adults are estimated to have multiple sclerosis in England.

NICE has previously recommended several treatments for multiple sclerosis including natalizumab, fingolimod, teriflunomide, alemztuzumab and dimethyl fumarate. 

In relapsing remitting multiple sclerosis, people have distinct attacks of symptoms, which then fade away either partially or completely.

It is estimated that 3,700 people would be eligible for treatment with daclizumab as set out in the recommendations. By 2021/22 some 1,100 people are expected to be following this treatment option.

Commissioners indicate that people with previously treated active relapsing–remitting multiple sclerosis are currently likely to receive fingolimod or alemtuzumab and people with rapidly evolving severe relapsing–remitting multiple sclerosis currently receive natalizumab. 

These assumptions have been included in the resource impact calculations.

The Department of Health and Biogen Idec have agreed that daclizumab will be available to the NHS with a patient access scheme that makes it available with a discount. The size of the discount is commercial in confidence.

There may be savings resulting from reduced administration costs associated with daclizumab compared with natalizumab, which needs infusion inpatient visits.

This technology is commissioned by NHS England. providers are NHS hospital trusts.

A resource impact template is available at www.nice.org.uk to help organisations plan for implementation of the guidance.