If you have PPMS, and live in Europe, you are one step closer to having a disease-modifying therapy for your MS.
If you have PPMS and live in England you have to wait for NICE to determine whether or not ocrelizumab is a cost-effective treatment to slow down your disease progression. To help manage expectations I anticipate NICE saying no for the PPMS indication. Ocrelizumab will be priced for the RRMS indication and not PPMS. The impact of ocrelizumab on disease progression is less in PPMS compared to RRMS and because it will be compared to 'best supportive care' for PPMS it is unlikely to be deemed cost-effective. One solution to this impasse is for differential pricing, i.e. for Roche to charge the NHS much less for PPMS compared to RRMS. Is Roche and the NHS ready for differential pricing? I am not sure. However, the NHS accounting mechanisms are in place to do this. It will be interesting to see how the NICE negotiations play out. EMA information on ocrelizumab.