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Government money for multiple sclerosis patients could be better spent

February 12, 2003

The National Institute for Clinical Excellence (NICE) has announced that neither interferon beta nor glatiramer can be recommended for multiple sclerosis in the NHS. However, the UK government plans to make these drugs available through a risk sharing scheme, despite limited evidence of clinical and cost effectiveness.

Researchers in this week's BMJ argue that the money would be better spent on independent trials.

To reach their decision, NICE considered data from placebo controlled trials of interferon beta and glatiramer acetate, but did not assess azathioprine, which has also been widely tested in multiple sclerosis. Trials show that azathioprine (which is 20 times cheaper) may be just as effective, say the authors.

Uncertainty also remains about the clinical and cost effectiveness of interferon beta and glatiramer (especially over the long-term duration of the disease), and the government's proposed risk sharing scheme is, according to the authors, scientifically unsound and impractical.

Any additional resources for patients with multiple sclerosis are welcome, but should be used to provide services that will benefit more than just the minority of patients eligible for interferon or glatiramer, they argue. Government money would be better spent on a long term trial comparing interferon beta or glatiramer with azathioprine and no treatment.

All patients with multiple sclerosis deserve much better than this. The government should consider a more appropriate use of this large amount of public money, they conclude.

British Medical Journal (BMJ)

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