Scottish Medicines Consortium considers wider rollout of take-at-home tablet for multiple sclerosis

A take-at-home tablet for multiple sclerosis (MS) could be more broadly rolled out on the NHS, potentially benefiting thousands of patients in Scotland.

The Scottish Medicines Consortium (SMC) is reviewing cladribine for wider use in relapsing forms of the condition, which affects more than 17,000 people across the country.

The tablet is being rolled out to more people living with MS in England from Wednesday in a bid to free up clinical time by reducing the need for hospital appointments.

A spokesperson for the SMC said: “It is the aim of the Scottish Medicines Consortium to provide timely advice on the clinical and cost-effectiveness of all new medicines for NHS Scotland.

“Cladribine was previously accepted in 2018 for the treatment of adult patients with highly active relapsing multiple sclerosis. We are currently reviewing cladribine for broader use in relapsing forms of multiple sclerosis.”

The health service in England is thought to be the first in Europe to widely rollout cladribine, also known as Mavenclad and made by Merck.

It has been approved by the National Institute for Health and Care Excellence (Nice) for people with relapsing-remitting MS.

This means they have periods where their symptoms get worse, followed by periods of recovery.

Cladribine is a chemotherapy drug and kills certain white blood cells made by the immune system known as T and B cells.

These cells normally attack viruses and bacteria, but in people with MS, they attack the covering around nerves in the brain and spinal cord known as the myelin sheath.

Cladribine stops these cells from entering the brain or spinal cord and attacking the nerves there. It is taken for 20 days spread over four years, reducing the need for hospital visits and extensive monitoring.

Cladribine was previously only recommended for patients with severe, highly active MS.

Laura Thomas, head of policy at the MS Society, welcomed the news.

She said: “Over 150,000 people live with MS in the UK, and many of them rely on disease modifying therapies like cladribine to help reduce MS relapses, so expanding patient choice is vital.

“Cladribine is self-administered, so this decision could particularly benefit people who’d struggle to go into hospital regularly, like younger working-age adults.

“It will also benefit patients considering starting a family, as it’s safe to get pregnant six months after the final course of treatment – which is less restrictive than many other DMT options.

“We’re so glad that more people with MS will now be able to choose an effective treatment which suits their lifestyle.”