This is a post for MSologists working in England. Yesterday I received confirmation from NHS England that they have not yet green-lighted a third course of alemtuzumab. In addition, I was told not to bypass the current NICE guidance by simply opening up another entry for a specific patient on Blueteq (Blueteq is the online system the NHS uses for high-cost drug vetting and accountability). I am aware that some of my colleagues have been doing this.
Not being able to offer a 3rd course is a problem in that an IFR (individual funding request) will not be processed as there will be more than 20 patients in England eligible for a third course. This situation has also put me in an awkward position as I have counselled most of my patients that about 40-50% of them will need a 3rd course.
I already have two patients who have broken through after the second course and we have to treat them with alternative DMTs. The latter is not a satisfactory solution to the problem. I sincerely hope Genzyme is getting the EMA label changed, on which the NICE guidance is based, to allow subsequent courses of treatment.