Access to Sativex and cannabis-based medicines
Sativex
In June 2010 the UK Medicines and Healthcare products Regulatory Agency (MHRA) licensed Sativex for use as an add-on treatment for MS-related spasticity when people have shown inadequate response to other symptomatic treatments or found their side effects intolerable. Sativex is the first cannabis-based medicine to be licensed in the UK.
Despite this approval, people with MS continue to have difficulty accessing Sativex.
The drug has not been appraised by NICE and so the decision whether or not to fund treatment is down to local PCTs and funding boards. Many have chosen not to citing cost and lack of evidence for efficacy and safety - for example, The Midlands Therapeutics Review & Advisory Committee guidance (pdf 184kb) was published in February 2011.
The MS Trust has responded to draft guidance on Sativex funding from several funding boards.
- East Midlands Specialised Commissioning Group
- South West Peninsula Health Technology Commissioning Group
Nicola Russell, MS Trust Director of Services said, "Now that Sativex is finally licensed, the NHS is refusing to pay, and this is very difficult for those people with MS who have intractable problems that the drug might help. The MS Trust calls on commissioners to accept that Sativex should be made available to the small number of people for whom it is appropriate. The cost of prescribing Sativex is tiny compared to the cost of treating problems associated with spasticity and spasms, such as complex contractures, pressure sores and severe disability. The NHS needs to face its responsibilities and not hide behind other issues such as lack of guidance from NICE."
Cannabis-based medicines
A great deal of accumulated anecdotal evidence over many years shows that some people with MS find cannabis useful in managing some symptoms. There is also a growing evidence base of effectiveness from research trials.
Results from research trials into cannabis-based medicines have highlighted how a healthcare professional's judgement of a change in symptoms (known as 'outcome measure') may not tally with the person with MS's view.
The MS Trust campaigns actively for bodies such as the MHRA to recognise that outcome measures based on the view of people participating in research trials are as valuable as a health professional's assessment.
Pam Macfarlane, Chief Executive of the MS Trust said, "We have been aware for a long time, based on comments from people with MS, that cannabis-based medicines can significantly improve spasticity, which is a common, complex symptom of MS. For this reason the MS Trust has campaigned for the availability of a licensed medicine that can be properly controlled and prescribed. We have also invested money and resources in developing the body of knowledge by funding clinical research into the effectiveness of cannabis-based medicines."