Patients with relapsing-remitting multiple sclerosis (MS) are now able to get treatment with Genzyme's Lemtrada (alemtuzumab) on the National Health Service in England and Wales, after cost regulators published final guidance recommending the drug as an option as per its licensed indication.

The news is especially welcome given that last year the National Institute for Health and Clinical Excellence was minded not to recommend Lemtrada because of gaps in data, but Genzyme's subsequent clarifications on the evidence it submitted were enough to sway its position.

Currently-available treatments for relapsing-remitting MS are either pills or injections given several times a week, but Lemtrada is taken intravenously once a year for two years (the first course being administered for five consecutive days and the second for three), offering a more convenient dosing regimen and greater freedom for patients.

Nick Rijke, Director for Policy and Research at the MS Society, said NICE's approval of the drug is "a major step forward in MS treatment".

“This drug has taken decades to develop, and while it’s not without risk, it’s proven to be a highly effective medicine for people with relapsing remitting MS,"  he noted.

The price of Lemtrada is £7,045 per 12mg vial, which equates to £56,360 for the full course of treatment. 

Stelara ousted

Elsewhere, the news was not so good for patients with psoriatic arthritis after the Institute issued a final no for Janssen's Stelara (ustekinumab).

The Committee concluded that the drug is not a cost-effective treatment option for patients after findings that the most plausible incremental cost-effectiveness ratio (ICER) for the drug is likely to exceed £30,000 per quality-adjusted life year (QALY) gained. 

“The Committee accepted that ustekinumab is clinically effective compared with conventional DMARD treatment, but the Committee concluded that ustekinumab appeared less effective than TNF alpha inhibitors," said Sir Andrew Dillon, NICE chief executive, explaining the decision.