Who is eligible for
Disease Modifying Drugs?

Not everyone with MS is eligible for Disease Modifying Drugs, and not everyone would benefit from having them.

The supply of DMDs on the NHS is tightly regulated. It is administered under a special scheme between the NHS and the manufacturers of the drugs known as the Department of Health Risk Sharing Scheme.

Who can be considered for DMDs?
The Association of British Neurologists ABN has agreed on the criteria for which patients are eligible to start taking DMDs and suggested guidelines on who should stop taking disease modifying drugs. These criteria are based on the results of clinical trials of the drugs which indicated which patients would benefit. It all depends on which kind of MS you have, and which drug is being considered. DMDs have been shown to be effective for some people with two of the types of MS: relapsing remitting and secondary progressive.

Let's look in detail at the criteria which the ABN uses for each of the types of MS:

a) For those with relapsing remitting MS who are considering beta interferon

The ABN guidelines say that all of the following criteria need to be met before you can be considered for treatment with one of the beta interferon treatments

• You must be able to walk independently (with an EDSS of 6.5 or less)
  
• You must have experienced at least two clinically significant relapses in the last 2 years
• You must be 18 or older*

For those with relapsing remitting MS who are considering glatiramer acetate

• You must be able to walk at least 100 metres without assistance
• You must have experienced at least two clinically significant relapses in the last 2 years
• You must be 18 or older*

b) For those with Secondary progressive MS who are considering beta interferon

The ABN guidelines say that all the following criteria must be met for starting on treatment with beta interferon.

• You must be able to walk (at least 10 metres with or without assistance)
• You must have experienced at least two disabling relapses in the last two years
• You must have experienced minimal increase in disability due to slow progression over the last two years.

Glatiramer Acetate is not available for those with secondary progressive MS (it has not been tested in this type of MS)

* Although there is no trial evidence available for people aged less than 18 years, the Department of Health's circular on the Risk Sharing Scheme (HSC 2002/004) says: "Neurologists may use their clinical judgement on whether to admit patients under 18 for treatment under the scheme."