#NewsSpeak: another eagle has landed - daclizumab

Finally people with MS get a new treatment option with some interesting attributes. #NewsSpeak #MSBlog #Daclizumab

Good news for pwMS living in England; NICE have deemed daclizumab to be cost effective to treat pwMS with more active MS and in whom alemtuzumab is contraindicated or otherwise unsuitable. As always the drug has been made available to the NHS at a discounted price. Having daclizumab as a  treatment option widens the choice for pwMS, in particular pwMS at high-risk of PML on natalizumab. Daclizumab is given monthly by subcutaneous injection. The downside of daclizumab is the need for monthly liver function tests to monitor for inflammatory liver disease that occurs in ~2% of treated subjects. However, pwMS who respond to daclizumab do well and tolerate the drug without major problems. Daclizumab has an interesting mode of action and is not overtly immunosuppressive that may make the drug appealing to some pwMS. 

Patient access schemes, or secret discounting to the NHS, is something the US Republican senators are very unhappy about. In short the Republicans are furious about the fact that US taxpayers are subsidising drug development, and drug pricing, for rich European countries, in particular the UK. They are very unhappy with the deals Pharma are doing with the NHS via NICE. I have been told that high on the US agenda when the UK tries to negotiate a trade deal with the USA post-BREXIT is the abolition of NICE and patient access schemes. To the neoliberals in the USA NICE and patient access schemes are anti-competitive. The question is what will our government be prepared to concede to the US to get a trade deal in place? Will they sacrifice cost-effective drug pricing? I sincerely hope not, we really need some counterbalances to excessive drug pricing. An example of this that will test NICE's mettle is Biogen's price for Spinraza a new treatment for a rare genetic disorder called spinal muscular atrophy ($750,000 for the first 6 doses). SMA is in general a fatal disease and hence will be a very emotive HTA (health technology assessment). Will NICE deem this drug to be cost effective for the NHS? Will NICE get a discount from Biogen as they have done for daclizumab?  

The interesting thing is that Obama created PCORI (Patient-Centered Outcomes Research Institute) to try and do the same thing for the US as NICE has done for the NHS. Will the Republicans close down PCORI? 

CoI: multiple

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