Wednesday, 21 June, 2000, 11:38 GMT 12:38 UK
Beta interferon can reduce the severity of MS attacks A preliminary report by the National Institute for Clinical Excellence suggests that the multiple sclerosis drug beta Interferon should not be made available on the NHS. BBC News Online talked to two doctors on opposite sides of the debate.
Dr Lorna Layward, head of research, Multiple Sclerosis Society
"Beta Interferons have been shown in numerous clinical trials to be an effective and safe way to treat multiple sclerosis.
"A great deal of work has been done, and the evidence is overwhelming that beta interferons can reduce both the number and the severity of relapses that people with MS suffer.
"Trials have shown that they can reduce the number of relapses by a third on average, and some people who take the drugs actually stop having relapses completely.
"There is no question that these drugs work, and that they can make a substantial difference to the quality of life for people who suffer from MS.
"Relapses can be distressing, painful and disabling. They vary greatly in severity, but extreme attacks can result in blindness, paralysis and incontinence and may require hospitalisation.
"It has been shown that people taking beta Interferon need less hospital treatment, therefore saving money for the NHS.
"Beta interferons do not work for all MS patients, but it estimated that about half would achieve substantial relief of their symptoms by taking the drugs. Those patients for whom beta Interferons make no difference can simply be taken off the drugs.
"There are no drugs that work for 100% of people - that is just not the real world.
"This is not an either-or situation. There are no other alternative drugs available and services such as rehabilitation or physiotherapy can never stop the progress of the disease. We have to decide whether MS is worth treating or not.
"It would be very sad if people with MS are going to be denied the only treatment that can be shown to alter the course of the disease. We would be out of step with the rest of the world.
"People would either have to pay for their own drugs, which are very expensive, or they would have to leave their own country."
Dr Peter Rothwell, consultant neurologist, Radcliffe Infirmary, Oxford:
"Beta interferon is not cost effective.
"Several trials of beta Interferon have been carried out in both the early and late stages of multiple sclerosis.
"In the early phase of the disease, the relapsing-remitting phase, where there is relatively little disability, but short attacks of symptoms, it has been shown unequivocally that beta Interferon reduces the frequency of these attacks of new symptoms by about a quarter to a third.
"However, there is no good evidence that treatment has any effect on the progression of disability.
"Taken together, the trials in the later stages of the disease, the progressive phase, have also failed to show consistent evidence of a slowing of the progression of the disability associated with multiple sclerosis.
"So a patient taking beta Interferon may have a few less attacks of symptoms early on, but at the end of five years there is no evidence that they are as less likely to be disabled than if they had not taken the drug.
"If beta Interferon cost £5, £100 or even £1,000 a year, the minor benefit it brings in terms of relieving symptoms might be worthwhile, but because it costs £10,000 per patient per year it is not cost effective.
"It would cost £250,000 to give beta Interferon to five patents
for five years. For the same cost one could employ one, or maybe two MS
nurses or physiotherapists who could work on reducing the physical impact
of the disease help a far larger number of patients."