Patient access to new treatments for multiple sclerosis

Lord Walton of Detchant asks why the UK is slow to adopt remedies for multiple sclerosis compared with its European neighbours. Multiple sclerosis is one of the commonest disabling neurological disorders, in which plaques of demyelination (degeneration of myelin sheaths of nerve fibres) develop in various parts of the brain and spinal cord. It is variable in its incidence and severity, in that some cases are relatively mild, some run a relapsing and remitting course with substantial intervals between episodes, which nevertheless lead to progressive disability, while in other patients the condition is rapidly progressive, with few if any remissions. Within the last 20 years several new immunosuppressive treatments, shown to be variably effective in reducing relapses and even in speeding more rapid recovery from such episodes, have been developed. Foremost among these have been the interferons, administered by a course of injections, and several other immunosuppressants, also needing to be injected, have emerged and have proven to be of variable but nevertheless proven value. These drugs work in different ways, but all effectively influence the immune system, since there is good evidence that, while in multiple sclerosis there may be a fairly weak element of genetic susceptibility, the principal process damaging the myelin is disordered autoimmunity; it is believed that this process may be precipitated by exposure to a variety of environmental agents, such as infective agents including viruses, although no single specific virus has ever been implemented. Within the last year a new remedy, fingolimod, which can be administered orally thus avoiding the need for injection, has been launched and has been shown by clinical trials to be effective, but as yet it has not been approved by the National Institute for Health and Clinical Excellence (and it is more expensive than most other remedies). The starred question I have tabled draws the attention of Her Majesty's Government to the fact that, for reasons which are difficult to explain, the number of patients with multiple sclerosis receiving any of these remedies in the UK is substantially lower than in many other comparable countries, not least in the major countries of the European Union. Perhaps fear of side-effects, which are a small but significant hazard with all immunosuppressants, make neurologists and GPs in the UK more cautious than their continental colleagues, or is finance and restraint on NHS funding the real problem? is a former Liberal Democrat spokesperson for trade and industry (energy) (1998-2005), former chair of AHS-Emstar plc (1966-99) and held a variety of positions on the National Coal Board (1947-82). He was raised to the peerage in 1983 and sits on the Liberal Democrat benches.