The cannabis sativa plant extract Sativex is a cost-effective therapy for spasticity in multiple sclerosis (MS) and can be offered to patients in England needing it on at least a monthlong trial basis, the National Institute for Health and Care Excellence (NICE) said in issuing a final recommendation on the treatment.
This decision reverses a previous draft guidance that NICE, which evaluates treatments and makes recommendations on health and social care in the United Kingdom, released in August.
Under the new guidance, Sativex will be available through local National Health Service (NHS) authorities for people with moderate-to-severe MS-related spasticity, who were not helped by other spasticity treatments, for an initial four weeks. If their symptoms are found to have eased by at least 20% with Sativex’s use at this trial period’s end, patients may continue taking the medication.
GW Pharmaceuticals, which markets Sativex, must also make this treatment available to the NHS “according to its pay-for-responders scheme,” NICE said.
Spasticity is one of the most common MS symptoms, causing muscles to feel stiff and heavy, and making movement difficult. It is an unwieldy symptom because it may or may not manifest regularly, and can differ from person to person or even within the same person at various times. The condition, which can range from mild stiffness to painful and severe muscle spasms, is estimated to affect about 60% to 90% of MS patients at some point.
“As a charity, we have campaigned over a long period for Sativex to be widely available, and we are delighted that NICE has listened to our calls for a fair assessment of its cost effectiveness. We know that access to this drug will greatly improve quality of life for many in the MS community. At the same time, we also recognize that some local health authorities will not be able to fund continued treatment with Sativex. The challenge ahead is to ensure that everyone eligible can access this treatment,” Martin added.
Sativex is a mouth spray containing equal amounts of two cannabinoids: tetrahydrocannabinol (THC) and cannabidiol (CBD). The number of sprays is gradually increased daily until a dosage is reached that, with the fewest side effects, relieves muscle stiffness.
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