A multi‐district model for the management of disease‐modifying treatments in multiple sclerosis

This paper’s objective is to develop a model for the appropriate and equitable use of disease‐modifying treatments in multiple sclerosis. The prevalence and incidence of multiple sclerosis was established in Leeds. A specialist multiple sclerosis team with two consultant neurologists and a multiple sclerosis support nurse was based at one centre. The team co‐operated with purchasers to develop a model of care. This included a referral protocol, strict prescribing criteria, counselling and education of patients, the use of patient‐centred outcome measures and training and feedback to other neurologists. A total of 217 people with multiple sclerosis were assessed from April 1997 to March 2000. Our experience suggests that a centralised multi‐district clinic developed by close collaboration between clinicians and health purchasers and operating under agreed rules is a feasible and effective model for the managed introduction of new treatments to the NHS.