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Mr. Burstow: The Minister is further illuminating the subject, and I am grateful for that. Would the Government regard it as unethical to have a clinical trial that effectively ring-fenced the prescribing of beta interferon so that it was not available outside the trial?

Mr. Hutton: If the hon. Gentleman will be patient, I will come on to what NICE is doing about that. If I do not get to that point by the end of play, I will certainly write to the hon. Gentleman and give him the details that he seeks.

In the light of the progressively expanding evidence base, the health technology assessment programme has gone on to commission secondary research in the broader field of MS treatment. In consultation with clinical neurologists and representatives of the Multile Sclerosis Society, reviews are being commissioned on the five topic areas identified as being of greatest clinical, patient and policy concern.

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There are other funding streams that we make available to support work in that general area, including funding that we make available directly to the Multiple Sclerosis Society, under the section 64 scheme. We are funding several projects, one of which involves developing and maintaining databases on MS treatment and trials so that clear and authoritative information can be given to people with MS.

The hon. Gentleman spent most of his time talking about problems surrounding the availability of beta interferon. I want to address the concerns that he and many other hon. Members have expressed in recent debates in the House.

The Government have a substantial agenda of work in place that is designed to improve the quality of treatment offered by the NHS. As the hon. Gentleman will be aware, that includes setting up NICE, the introduction of clinical governance and improving the way in which the NHS commissions and uses research. However, we of course recognise that the licensing and prescribing of beta interferon is an issue of concern.

I understand that evidence is that beta interferon drugs reduce the rate of relapses in relapsing-remitting MS by some 30 per cent.--the hon. Gentleman referred to that--on average in a range from 14 to 44 per cent. Betaferon was licensed for treating secondary progressive MS on the basis of evidence that, if used for three years, it might delay disease progression by up to one year.

Clinicians treating patients and those advising health authorities on their overall policy need to take account of both the clinical effectiveness and cost-effectiveness of beta interferon. It appears that there is evidence that some patients with relapsing-remitting and secondary progressive forms of multiple sclerosis can benefit from the use of beta interferon, but that, sadly, those short-term improvements are temporary. The cost of beta interferon treatment is estimated at approximately £10,000 a year per patient.

Let me make it clear that the Government are committed to improving standards of health care and to ensuring that, when newer treatments, including new medicines such as beta interferon, represent a genuine therapeutic advance and are cost-effective, they are introduced into the national health service as fast as possible. In fact, beta interferon has taken on an even higher profile since its licence was extended to the treatment of secondary progressive MS at the beginning of last year.

Not surprisingly, the licensing of beta interferon has for the first time given people with MS some hope that there might be a pharmaceutical remedy for their condition. However, it is terribly important that no one raises any false expectations about the ability of beta interferon or any other drug to combat MS. To be fair to the hon. Gentleman, he made that point clearly, too. Beta interferon is not a cure for multiple sclerosis; there is no cure for MS.

Evidence from trials on the clinical effectiveness and cost-effectiveness of beta interferon appears to many commentators to be far from clearcut. That is why different health authorities and their clinicians are arriving at different conclusions, which can result in differences in the pattern of provision of beta interferon. That is exactly

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why we have asked NICE to carry out an authoritative appraisal of the evidence. The work of NICE is the common-sense way in which to end the variations that the Conservatives' internal market did so much to create.

The great advantage of NICE is that it brings together the expertise not just of clinicians, but of managers and of patient groups, in order to make an authoritative assessment of evidence emerging from trials. NICE guidance will support front-line clinicians and help to reduce the confusion, which I am perfectly prepared to

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accept currently exists. I obviously cannot pre-empt what NICE will conclude, but I think that it is undisputed that the NHS should seek to use its resources to achieve the greatest possible health gain for patients. With this in mind--

The motion having been made after Ten o'clock, and the debate having continued for half an hour, Mr. Deputy Speaker adjourned the House without Question put, pursuant to the Standing Order.



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