Natalizumab (originator and biosimilar) for treating highly active relapsing–remitting multiple sclerosis after disease-modifying therapy

Natalizumab originator (Tysabri, Biogen) and natalizumab biosimilar (Tyruko, Sandoz) are indicated as a 'single disease-modifying therapy in adults with highly active relapsing–remitting multiple sclerosis (RRMS) for the following patient groups:

• Patients with highly active disease despite a full and adequate course of treatment with at least one disease-modifying therapy (DMT)
  or

• Patients with rapidly evolving severe RRMS defined by 2 or more disabling relapses in one year, and with 1 or more Gadolinium enhancing lesion on brain Magnetic Resonance Imaging (MRI) or a significant increase in T2 lesion load as compared to a previous recent MRI.'

The dosage schedule for natalizumab originator (subcutaneous and intravenous) is available in the summary of product characteristics for natalizumab originator.

The dosage schedule for natalizumab biosimilar (intravenous) is available in the summary of product characteristics for natalizumab biosimilar.

The list prices for the natalizumab originators are:

• £1,130 per 300 mg/15 ml concentrate for solution for intravenous infusion vials (excluding VAT; BNF online, accessed February 2025).

• £1,130 per 2x150 mg syringe for subcutaneous injection (company submission).

The list price for the intravenous natalizumab biosimilar is £1,017 per 300 mg/15 ml concentrate for solution for infusion vials (excluding VAT; BNF online, accessed February 2025).

The companies that make the natalizumab originator and the natalizumab biosimilar have agreed a nationally available price reduction for natalizumab with the Medicines Procurement and Supply Chain. The prices agreed through the framework are commercial in confidence.

For information, the Carbon Reduction Plans for UK carbon emissions are published on Biogen's webpage on responsibility and Sandoz's website.