MTRAC has issued two new Commissioning Support reviews in June 2012. The reviews cover fampridine for walking disability in multiple sclerosis and dabigatran for stroke prevention in patients with atrial fibrillation.
Fampridine (Fampyra®) was considered unsuitable for prescribing in primary care and having a lower place in therapy with relatively weak evidence.
Dabigatran (Pradaxa®) was considered suitable for prescribing in primary care as an option. The committee recommended that warfarin remains first line with dabigatran having lower place in therapy despite relatively strong evidence. This lower place in therapy is made with regard to higher acquisition costs, unknown long-term safety and lesser opportunity to assess adherence to treatment.
Action: Clinicians should be aware of these reviews and compare current practice to the recommendations, making changes where appropriate.