Reducing frequency and severity of relapses will be of great clinical benefit

Editor-Richard G Richards's editorial on interferon beta in multiple sclerosis deals with the “clinical cost effectiveness” of the drug in the disease, but it lacks a fair balance, emphasising the cost effectiveness and minimising the clinical effectiveness of the drug.1 Richards states that “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.” This is his personal judgment and does not reflect the needs and wishes of patients with multiple sclerosis and their families.

Multiple sclerosis is a distressing, humiliating, and often long drawn out disease with no cure. For this reason, quality of life, for the patients and their families, is paramount. A drug that can reduce the frequency and severity of relapses, whether or not it diminishes the progression of the disease, will be of great clinical benefit to many patients, improving their situation physically, psychologically, and socially. Surely happiness, feeling better, and increased health have great value. This is what many of us believe that the practice of our profession is about.

Current policy is sensible

Editor-The NHS Executive's position on interferon beta allows individual hospital doctors, working within certain parameters, to decide with a patient with multiple sclerosis whether to start treatment with the drug. This sensible standpoint comes in for varying degrees of criticism in three recent articles, mainly on the grounds of health economics.1,2,3 The authors are all proponents of evidence based policymaking but are happy to assert that an effect on disability is the most important outcome measure in this disease without producing any evidence to support their view. Many people with multiple sclerosis would consider a reduction in the number of relapses to be valuable. We do not withhold treatments that give important symptomatic relief in …