NHS England Introduces Fampridine for Walking Difficulties in Multiple Sclerosis

NHS England has announced that, effective immediately, thousands of people living with multiple sclerosis (MS) across England will be able to access fampridine (Fampyra) through routine NHS care. The medicine is the first licensed therapy specifically designed to improve walking ability in adults with MS, offering a new treatment option for patients experiencing mobility challenges associated with the disease.

The decision represents an NHS England commissioning policy rather than a new regulatory approval, as fampridine is already a licensed medicine. The rollout follows a positive review by NHS England’s Clinical Priorities Advisory Group (CPAG), which evaluates specialized medicines, devices, and treatments that are not routinely assessed by the National Institute for Health and Care Excellence (NICE). The decision also brings access in England into line with that already available in Scotland, Wales, and Northern Ireland.

Fampridine is an oral medication taken twice daily. It helps improve the transmission of electrical signals along nerves damaged by MS, acting as a functional “signal booster” that enhances communication between nerves and muscles. For some patients, improved mobility could make everyday activities easier, supporting greater independence and quality of life.

Addressing an Unmet Need in MS Care

Multiple sclerosis is a chronic neurological condition caused by damage to nerves in the brain and spinal cord. Symptoms vary between individuals but commonly include muscle weakness, fatigue, sensory disturbances, balance problems, coordination difficulties, and impaired walking ability. Until now, management of MS-related walking difficulties has largely relied on physiotherapy, exercise programs, walking aids, foot-support devices, and treatments aimed at reducing muscle stiffness rather than medicines specifically developed to improve walking.

Clinical studies demonstrated that approximately 43% of patients treated with fampridine experienced clinically meaningful improvements in walking speed, with some also able to walk longer distances. Patients beginning treatment will undergo an initial 2 to 4-week assessment period, during which their walking ability will be evaluated before and after therapy. Those who demonstrate a meaningful clinical benefit may continue treatment with regular reviews, while patients who do not experience sufficient improvement will discontinue therapy.

Eligibility and Expected Impact

NHS England estimates that approximately 5,000 people living with MS could be eligible for fampridine treatment during the first year of routine availability.

The medicine will be offered to adults with any form of MS whose walking difficulties are assessed as having an Expanded Disability Status Scale (EDSS) score between 4 and 7, representing individuals with moderate to severe walking impairment. This includes patients who can walk independently for approximately 500 metres without assistance through to those who are largely wheelchair-dependent and unable to walk more than a few metres without support.

The commissioning decision follows CPAG’s assessment of the medicine’s clinical benefits and value for money, expanding access to a targeted treatment option for one of the most disabling symptoms of multiple sclerosis.

Patient and Expert Perspectives

Professor Frankie Swords, NHS National Medical Director, said walking difficulties can have a profound impact on the freedom and independence of people living with MS. She noted that fampridine has the potential to be “life-changing” for thousands of patients by improving mobility and enabling them to carry out everyday activities with greater confidence and independence.

Professor James Palmer, National Medical Director for Specialised Services at NHS England, said that providing access to a treatment specifically developed to improve walking offers renewed hope for people with MS who have previously relied primarily on physiotherapy, mobility aids, or assistance from others.

Patient advocate Aysen Slack, who previously paid for fampridine privately before stopping treatment because of the ongoing cost, welcomed the NHS decision. She said the medicine had previously improved her walking ability and expressed optimism about being able to access the treatment again through the NHS.

Significance for MS Treatment

According to the MS Society, more than 120,000 people live with MS in England, and fampridine remains the only licensed medicine specifically indicated to improve walking ability and walking speed in some people with the condition. For eligible patients who respond to treatment, improved mobility may support greater independence, continued employment, and improved participation in everyday life.

Clinical Access and Implementation

With NHS funding now in place, eligible patients across England will be able to undergo assessment for fampridine treatment, with continued access dependent on demonstrated improvements in walking performance during the initial evaluation period. The introduction of routine NHS funding provides eligible patients with access to the first licensed medicine specifically intended to improve walking in multiple sclerosis, expanding treatment options for one of the condition’s most disabling symptoms while reinforcing ongoing efforts to improve care for people living with long-term neurological conditions.

 Reference

NHS England » Thousands with MS to get “life-changing” drug on NHS to help them walk more freely