LONDON (Reuters Health) - Assessing up to 30,000 multiple sclerosis (MS) patients for eligibility to take part in a new scheme to receive beta-interferon and glatiramer acetate looks like a major task for Britain's 400 neurologists.
Beta-interferon and glatiramer acetate are used in many countries to slow disease progression. But in Britain most MS patients have been denied the drugs following controversy over their long-term effectiveness and cost. Under the new scheme, the government will continue payments for the drugs if they prove effective. If not, payments to firms that make the drugs will be reduced on a sliding scale.
To be eligible, each patient will need to be assessed by a neurologist. Those who meet criteria set by the Association of British Neurologists (ABN), including those with relapsing/remitting MS and secondary progressive MS, in which relapses are the dominant feature, can be prescribed these drugs on the NHS.
It is thought that as many as 10,000 patients may be eligible, although the ABN estimates that two or three times that many will need to be assessed.
Considering some patients already wait up to 12 months for an appointment, it is clear that extra resources will be needed to implement the plan, the ABN said in a statement.
"We have concerns that while there are significant drug costs to the scheme, that one doesn't lose sight of the human resource requirements," Professor David Chadwick from the ABN told Reuters Health.
"The problem initially could be in seeing and assessing an existing backlog of people with MS who may meet the ABN guidelines."
He said the screening process should be finished within 18 months.
Monitoring the efficacy of the treatments will also need extra resources, Professor Chadwick said. "The extra burden of collecting outcomes would be very similar to running a clinical trial," he said. "There are going to be competing pressures on neurologists.
However, the officials at the department of health "are making the right noises" about providing adequate funding, Prof. Chadwick said.
"We know that the department intends
to ensure that the required additional therapies and infrastructure are
provided through health authorities and primary care trusts without compromising
existing services," according to a statement from ABN, the Multiple Sclerosis
Society, the MS Trust and the UK MS Specialist Nurses Association.
Reuters Health Information 2002. © 2002 Reuters Ltd