People with relapsing-remitting MS can only be treated with ocrelizumab if alemtuzumab is contraindicated or otherwise unsuitable. The latter is a very grey area and will be open to interpretation. My question is how does patient choice taken into account? NICE clearly does not think this is a priority; for NICE cost-effectiveness trumps patient safety and choice.
This appraisal does not refer to the primary progressive indication. If you think ocrelizumab has had a hard time in RRMS it is going to have an even harder time in PPMS.