1 Recommendations

1.1 Ponesimod is recommended for treating relapsing–remitting multiple sclerosis with active disease defined by clinical or imaging features in adults, only if the company provides ponesimod according to the commercial arrangement.

1.2 This recommendation is not intended to affect treatment with ponesimod that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop.

Why the committee made these recommendations

Ponesimod is a disease-modifying treatment for multiple sclerosis. There are other disease-modifying treatments in routine clinical use.

Clinical trial evidence shows that people who have ponesimod have fewer relapses than people who have teriflunomide. Its effect on disability progression is not clear. Comparisons with other disease-modifying treatments are uncertain because of limitations in the clinical evidence.

The cost-effectiveness estimates are also uncertain, because of limitations in the clinical evidence and how long-term clinical benefit is predicted from short-term evidence. However, taking this uncertainty into account, the estimates are below what NICE normally considers an acceptable use of NHS resources. Therefore, ponesimod is recommended.