The Risk Sharing Scheme

The National Institute of Clinical Excellence (NICE) conducted an appraisal of the use of Disease Modifying Drugs (interferon beta and glatiramer acetate) back in 2001. They considered that these treatments did not represent a cost effective use of NHS resources because of their very high cost relative to the benefit received by patients on average.

However, because some patients clearly experience benefit from disease modifying drugs, they invited the Department of Health and the Welsh Assembly Government to consider what could be done to enable the medicines to be provided to patients on the NHS in a manner that could be considered to be cost effective. The result was the issuing of Health Service Circular 2002/004 in February 2002.

The Health Service Circular laid out an agreement between the Department of Health, Welsh Assembly Government, Scottish Executive and Northern Ireland Department of Health, Social Services and Public Safety with the manufacturers for the supply of the DMDs on the NHS. This agreement created what is known as the 'Risk Sharing Scheme'. In this agreement the manufacturers agreed that their products would deliver certain outcomes and if these outcomes are not delivered the price that the NHS pays would fall, hence the risk sharing.

Between 2002 and 2005, over 5500 patients were entered onto the scheme through just over 70 neurology centres around the UK. As part of the process, their MS is monitored on an ongoing basis by external researchers.

The data collection phase of the Risk Sharing Scheme is now closed to new patients, but everyone who meets the criteria and wants to go onto interferon beta and glatiramer acetate continues to have access to them on the NHS under the scheme.