Patients in Wales with multiple sclerosis will be the first in the UK to get ‘routine’ access to Bayer Healthcare’s cannabis-based spray Sativex (delta-9-tetrahydrocannabinol/cannabidiol) on the National Health Service, after cost regulators approved its use for treating spasticity linked with the illness.

The All Wales Medicines Strategy Group is the first national assessment body to recommend Sativex for NHS use, as an option for improving symptoms in adults with moderate to severe MS spasticity who have failed to respond to other anti-spasticity drugs and who respond quickly to the therapy.

“Improved access to Sativex has been long awaited by clinicians and patients since its launch in 2010,” says Sajida Javaid, Consultant in Rehabilitation Medicine, Neath Port Talbot Hospital, noting that it is “encouraging to see that patients in Wales will now have improved access to a treatment that has been proven to provide significant relief from the spasms and cramps associated with spasticity”.

NICE ‘no’?

Across the border, reports suggest that sister organisation the National Institute for Health and Care Excellence (NICE) is somewhat more reluctant to endorse the drug’s use. 

In a letter to the Daily Telegraph back in June, the head of the MS Society, Michelle Mitchell, and seven leading neurologists and pain management experts, attacked the cost regulator over its stance on the use of Sativex as well as Biogen Idec’s Fampyra (prolonged-release fampridine).

They argue that, in what will be the first clinical guideline for MS in 11 years, NICE is proposing to block access to two “potentially life changing” therapies “which are licensed and proven to be effective at helping people walk more easily and control painful muscle spasms”.

The NHS price of Sativex is £125 per 10ml vial, but NICE is saying that, based on current analysis, Sativex is not a cost-effective option for the NHS, with its cost coming in at around £50,000 per QALY gained.

Bayer is offering a Patient Access Scheme under which it funds the first pack of the treatment - which was developed by GW Pharma - free of charge to help determine which patients will respond to the therapy.