As patents expire, fampridine is cleared for NHS use in MS

After a delay of several years, people living with multiple sclerosis in England will finally be able to get NHS access to fampridine, which has been shown to improve walking ability in trials.

Originally developed as Fampyra by Biogen, fampridine was rejected by England's health technology assessment (HTA) agency, NICE, on the grounds that it was not cost-effective, but has been covered by the NHS in Wales since 2019, Scotland since 2020, and Northern Ireland since 2023.

NICE's change of heart comes because the patents on Fampyra have now expired, allowing lower-cost, generic versions of fampridine to reach the market and change its cost-effectiveness calculations.

The twice-daily pill will be available to people with MS who have an Expanded Disability Status Scale (EDSS) score of 4-7, provided they have healthy kidney function and have never had a seizure or epileptic fit, according to the MS Society, which said NICE's decision "finally fixes a longstanding injustice."

Ceri Smith, the patient advocacy group's head of policy and evidence, said: "Over 120,000 people live with MS in England, and until now, many have been forced to pay privately for the drug or miss out altogether – despite fampridine being approved in the rest of the UK."

She added: "It's vital that MS services now have the support they need to make fampridine available to all people with MS who could benefit from it, regardless of where in England they live."

The MS Society also said that while fampridine has been approved elsewhere in the UK for some years, there are still obstacles to access and it is not yet available to all patients. It can be used in patients with any form of MS, but is only licensed to improve walking speed.

That means it can only be prescribed long-term for people whose walking speed improves, even if it helps with other symptoms such as fatigue. Without an improvement in walking speed, it will be discontinued after 30 days.

Until now, support for MS-related walking difficulties has largely involved physiotherapy and exercises, walking aids, devices to support the feet and treatments to manage muscle stiffness.

It is estimated that around 5,000 people living with MS will be eligible in England in the first year. They will have to be unable to walk further than five metres and be largely restricted to a wheelchair.

Aysen Slack, a 65-year-old from Eastbourne living with MS, was paying for fampridine privately for a while, but had to stop because of the cost.

"Fampridine seemed to be working well for me, but paying for the medication was a significant expense and I could not keep doing that forever. So I had to make the difficult decision to stop taking it," she said.

"I would definitely like to try fampridine again on the NHS. My mobility has decreased a lot, and even in my flat I have to use sticks now. It would make a huge difference to my life if I were able to improve my walking."