Biogen’s Fampyra (fampridine) has become the first treatment funded by NHS Scotland to improve walking difficulties in adult patients with all types of multiple sclerosis (MS), following a resubmission by the company.

The drug was initially turned down by the Scottish Medicines Consortium (SMC) late 2018 as it felt  there was too much uncertainty surrounding its value for money.

Now the cost watchdog has approved NHS funding for its use to improve the walking capabilities of adults with MS with walking disability (Expanded Disability Status Scale [EDSS] 4 to 7), but only in circumstances where the approved NHS Scotland Patient Access Scheme (PAS) is utilised or where the list/contract price is equivalent or lower than the PAS price.

“Walking problems affect most people with MS and losing independence as a result of reduced mobility is one of their greatest fears,” said Dr Simon Beck, medical director, Biogen UK & Ireland.

“Fampridine is the only treatment shown to improve walking ability in people living with MS-related walking disability, so today’s SMC decision could make a real difference to those with mobility challenges in Scotland and their carers, many of whom have been funding their own treatment until now.”

Elsewhere, Sanofi's Suliqua (insulin glargine/lixisenatide) was accepted for the treatment of type II diabetes.

Suliqua can be used alognside metformin when blood glucose (sugar) levels are not satisfactorily controlled with metformin and insulin alone, and so offers another treatment option fo patients.

Janssen's Stelara (ustekinumab) was endorsed by the SMC for the treatment of moderately to severely active ulcerative colitis, a disease which causes inflammation of the gut.

Patients with this condition can experience frequent diarrhoea, abdominal pain and fatigue, which can affect their ability to work and socialise. Stelara offers another treatment option and may help some patients to delay or avoid the need for surgery, the agency noted.

“Crohn’s & Colitis UK is extremely pleased that people in Scotland living with ulcerative colitis may now benefit from this treatment option. The personal impact of uncontrolled symptoms of colitis can be devastating and debilitating and can severely affect a person’s daily living and activity. Having many treatment options available to doctors is hugely beneficial for patient outcomes,” commented Elaine Steven, health service programme manager at the charity.

“This decision is particularly welcome during the COVID-19 crisis ensuring patients have access to a wide range of treatment options while supporting the NHS and IBD Services against further pressures on already stretched services. Our thanks go to the SMC for not delaying the publication of this decision at this critical time.”

Shionogi's Rizmoic (naldemedine) will now be funded on the NHS in Scotland to treat constipation caused by opioids (such as morphine).

Opioid-induced constipation is very common and can be extremely distressing for patients and very difficult to treat, do the drug will offer an alternative option for patients who have not responded to laxatives.