By Lord Walton of Detchant – 2nd February 2011
Lord Walton of Detchant calls for clarity in determining how multiple sclerosis care will be commissioned, following proposed restructures to the health service.
Multiple sclerosis is a chronic disease of the central nervous system involving the brain, spinal cord and sometimes the optic nerves. it is the commonest neurological disease affecting adults, involving approximately two million people worldwide and about 100,000 people in the UK.
Symptoms vary in severity; sometimes the disease is progressive but more often it is a relapsing and remitting disorder, in that episodes of weakness, numbness or visual failure occur but then recover wholly or in part, only for further such events to occur at a later date, often resulting ultimately in progressive disability.
Since the introduction of interferons in treatment some 20 years ago, these drugs and many more discovered since have been shown to be effective in reducing the severity of symptoms, in promoting remission and in delaying progression of the disease, particularly in the relapsing and remitting variety of the condition. These are so-called ‘disease-modifying drugs’.
Unfortunately, recent evidence shows that only about 12 per cent of patients with multiple sclerosis in the UK are currently receiving these remedies, and a report published by the department of health on medicines’ usage ranked the UK 13 out of 14 comparative countries with regard to MS drugs.
This finding is not consistent with the ten-year national service framework launched by the government in 2005 relating to the treatment of long-term conditions, and it is clear that substantial improvement in the availability of these drugs is needed.
The department of health introduced a risk-sharing scheme, enabling manufacturers of these drugs to share the cost of providing them while research was undertaken over a period of ten years to ascertain their long-term cost-effectiveness. it is unclear how future MS services will be commissioned, as between the new National Health Commissioning Board and local GP consortia, and this also needs to be clarified.
Lord Walton of Detchant Kt TD MA MD DSc FRCP FMedSci is a former consultant neurologist and professor of neurology. He was elevated to the peerage in 1989 and sits as a crossbencher.