NHS England Approves Fampridine for 5,000 MS Patients a Year

Q: England once called this MS drug too costly. What changed to make it a worthwhile NHS investment now?

It became a worthwhile NHS investment because England reassessed both the drug’s value and the way it would be funded and used. The key shift was a fresh NHS England review of the evidence. Officials concluded there was now enough proof that fampridine delivers meaningful benefit for a defined group of MS patients with walking problems. Trials showed about 40% of users improved walking speed and endurance, and the NHS will only continue treatment after a one-month trial if a patient shows a clear benefit, such as measurable improvement in walking or a strong patient-reported gain. That restricted rollout changes the cost-effectiveness equation. Instead of paying long term for everyone, the NHS is funding it only for adults who meet eligibility rules and then respond to the drug. That reduces waste and makes the treatment more targeted. Budget and prioritisation also changed. Fampridine was ranked through NHS England’s specialised commissioning process, and NHS England said sufficient recurrent funding had been secured to cover treatments in that priority band. The decision also implies that the commercial terms and price offered were acceptable within the updated appraisal. The result is that fampridine is no longer being judged simply as an expensive pill, but as a targeted, monitored treatment that can improve independence, mobility and, for some patients, the ability to keep working. That broader practical value helped tip the balance in favour of NHS funding.

Q: How will the NHS decide which patients lose access to a life-changing drug after the one-month trial?

The NHS will continue fampridine only for patients who show a clear benefit after the initial one-month trial; those who do not will lose access. In practice, that decision is expected to rest on both objective walking tests and the patient’s own report of whether the drug is helping. The additional guidance linked to the NHS rollout says treatment should be stopped if there is no meaningful improvement from baseline in measures such as the Timed 25-Foot Walk or the 12-item Multiple Sclerosis Walking Scale. A gain of about 20% in one of these walking measures is cited as the benchmark for continuing treatment. Doctors will also consider whether the patient reports a noticeable real-world benefit, such as easier walking, better endurance or greater independence. If there is no patient-reported benefit, the drug is expected to be discontinued even if the trial period has been completed. Eligibility is already restricted before the trial begins. The drug is intended for adults with MS-related walking problems, generally those with an Expanded Disability Status Scale score between 4 and 7, and prescribing is overseen by neurologists and specialist teams. So the NHS is not expected to make the decision on cost alone at the individual level after one month. It will be based on whether the patient can demonstrate measurable or clearly felt improvement during the short trial period.

3 articles · Updated · bbc.co.uk · Jul 22

Up to 5,000 people in England with multiple sclerosis will gain NHS access to fampridine each year, the first drug approved there specifically to improve walking.
Clinical trials showed about 4 in 10 patients improved walking speed and endurance, with the pill boosting nerve signals disrupted when MS damages myelin.
Patients will receive the drug for up to a month initially, and only those showing a clear benefit will continue treatment.
The decision reverses earlier NHS England rejections on value-for-money grounds; fampridine was already available in Wales, Scotland and Northern Ireland.
More than 120,000 people live with MS in England, though eligibility is limited to those with certain levels of walking difficulty.