Siponimod is not recommended, within its marketing authorisation, for treating secondary progressive multiple sclerosis with evidence of active disease (that is, relapses or imaging features of inflammatory activity) in adults. https://www.nice.org.uk/guidance/indevelopment/gid-ta10436/consultation/html-content-2
Interferon beta-1b is currently the only disease-modifying treatment available for people with active secondary progressive MS. However, NICE says that few people take it because it can cause side effects such as flu-like symptoms.
Clinical trial results show that siponimod reduces the number of relapses and slows disability progression compared with placebo. However, NICE explains that because there is no evidence directly comparing siponimod with interferon beta-1b, it is uncertain how effective siponimod is compared with that treatment. Because none of the analyses reflected the committee’s preferences and the clinical evidence was limited, the independent appraisal committee was unable to recommend siponimod for use in the NHS in England. The committee has requested further analyses to be included in the company’s economic model.
Siponimod costs £1,643.72 per pack of 28 tablets at its list price.
So subtext of response of NICE seems to be no different from normal…The treatment costs too much, bring down the price, give us abit more data and we’ll talk more.