Interferon beta in multiple sclerosis

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7066.1159 (Published 09 November 1996) Cite this as: BMJ 1996;313:1159
  1. Richard G Richards
  1. Consultant public health physician Department of Public Health and Clinical Practice, North Nottinghamshire Health, Mansfield, Nottingham NG21 0ER

    Clinical cost effectiveness falls at the first hurdle

    Interferon beta-1b has now been granted a product licence in Britain. The department of health recently issued an executive letter providing “guidance” on the introduction of interferon beta:1 purchasing authorities were asked “to initiate and continue prescribing of Beta-Interferon through hospitals.” This is the first time that the NHS Executive has issued such a directive.

    Data from the Multiple Sclerosis Study Group show that interferon beta-1b significantly reduces the number of demyelinated plaques on magnetic resonance imaging in patients with multiple sclerosis and reduces relapse rates by up to 30%.2 3 However, the studies showed no evidence of any reduction in the more clinically relevant endpoint—the progression of disability, which should be the goal of treatment. Patients treated with 8 MIU of interferon beta-1b avoided one in three relapses by the end of the second year and an average of 1.5 relapses over five years.4 At a minimum cost of £10 000 per year, this equates to £33 000 per relapse avoided.

    An average patient might experience 25–30 relapses in the course of …

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