OBJECTIVES: Due to recent technological advances, the multiple sclerosis (MS) treatment landscape over the past decade has seen notable change. Despite this patients, with MS are still considered to have a high unmet need and access to new therapies remains a challenge for EU health systems. The objective of this research was to assess the variability in patient access to a range of MS treatments in England, Scotland, Germany and France.

METHODS: Health Technology Assessment (HTA) appraisals performed by the National Institute for Health and Care Excellence for England, the Scottish Medicines Consortium for Scotland, the Institute for Quality and Efficiency in Healthcare/ Federal Joint Committee for Germany and the Haute Autorité de Sante (HAS) for France were reviewed in parallel. The treatments reviewed were alemtuzumab, cladribine, dimethyl fumarate, fingolimod, glatiramer acetate, interferon beta-1a, interferon beta-1b, natalizumab, ocrelizumab and teriflunomide.

RESULTS: The numbers of treatments fully reimbursed with no restrictions were five in England, three in Scotland, four in Germany and six in France. The numbers reimbursed with restrictions were five in England, five in Scotland, three in Germany and four in France. Total numbers of reimbursed treatments were therefore 10 in England, eight in Scotland, seven in Germany and 10 in France. The numbers of treatments not recommended were one in England, two in Scotland and one in Germany. All other treatments are under review or were not reviewed. In total, six out of the 12 therapies investigated have been assessed by HTA bodies in all four counties.

CONCLUSIONS: Despite advances in MS therapies there is still variable access to treatments across Europe. Patients in France have access to all of the therapies reviewed by HAS Patients in Scotland have the most limited access to MS therapies of all four countries.