Following the meeting on 6 March 2019, the appraisal committee asked NHS England and Biogen to enter into commercial discussions to see whether a managed access arrangement could be agreed for nusinersen (Spinraza) consistent with NICE’s framework for determining cost effectiveness. The outcome of these discussions and the consequences for guidance development for this topic will be considered by the committee on Wednesday 8 May. Given the nature of the discussion, this will be held in private.