The Scottish Medicines Consortium (SMC) said that the economic case for providing the drug on the NHS has not been demonstrated.
It calculated that the cost per quality adjusted life year (QALY) for natalizumab is £32,000 com-pared with beta interferon and £31,000 compared with glatiramer acetate.
But the SMC acknowledged that clinical evidence showed that, compared with placebo, natalizumab significantly reduced relapse rate in patients with rapidly evolving severe RRMS. Sustained progression of disability over two years was also significantly less likely in patients given natalizumab.
Natalizumab is believed to reduce inflammation and demyelination in MS by inhibiting migration of leukocytes into the central nervous system. It is licensed as a single disease modifying therapy in highly active relapsing remitting MS (RRMS) if patients have rapidly developing disease or do not respond to beta interferon.
MS charities said the decision left doctors with no treatment al-ternatives for these patients.
Patients will only be able to receive natalizumab if they fund the drug themselves or if Scottish health boards take the unusual step of overruling the SMC advice.
Chief executive of the MS Trust Chris Jones said: ‘Clinicians will be prevented from prescribing an effective licensed treatment to people in need. We urge people with MS to continue fighting for Tysabri on an individual basis.’
Mark Hazelwood, director of the MS Society Scotland, said: ‘No other drug has shown this poten-tial to reduce disability and any short-term savings are likely to be outpaced by the devastating financial costs of living with severe, progressive disability.
‘Longer-term, we are concerned about the implications this might have on the forthcoming NICE decision this summer,’ he added.