Multiple sclerosis: Time is brain
Time is brain is a call to action that is increasingly recognised and being heeded in the treatment of people with MS. By achieving the 100 day goal for diagnosis, treatment initiation, and support service provision, relapses and disability progression could be positively impacted, which in turn may reduce the long-term resource burden for many patients.
MS policy & guidelines
- NICE has produced an array of MS guidance and tools, predating the latest consensus statements on optimal MS standards for diagnosis and management. 2,3
- NHS England published a DMT treatment algorithm in 2018. 4
- Wales, Scotland and Northern Ireland have neurological care standards, although not MS specific. 5-7
- The revised McDonald MS diagnostic criteria (2017) ensures accurate diagnosis as early as possible. 8 MRI is key to clinically definite diagnosis.
The current situation
Time to diagnosis
Time to treatment initiation
The cost of delay: disease progression10
People with RRMS who do not access prompt DMT can experience more relapses and quickly accumulate a higher level of disability.
Disability impacts employment
MS affects employment, even at low levels of physical disability.10
54% of MS patients with an EDSS at or below 3.0 are not working.11
The complications associated with suboptimally managed MS create an under-recognised burden on NHS services & budgets.12
The most common reasons for emergency MS admission are avoidable complications.12
Hidden cost implications
Admissions related to MS comorbidities is a hidden and increasing cost to the NHS.12
100 day challenge: Optimal timeline for brain health 1
For more information please download our leaflet
- Hobart J, et al. International consensus on quality standards for brain health-focused care in multiple sclerosis. MultScler. 2018: 1352458518809326.
- NICE clinical guideline [CG186] Multiple sclerosis in adults: management (2014). Available at: www.nice.org.uk/guidance/cg186
- NICE quality standard [QS108] Multiple sclerosis (2016). Available at: www.nice.org.uk/guidance/qs108
- NHS England (2018). Treatment algorithm for multiple sclerosis disease-modifying therapies. Available at: www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2019/03/Treatment-Algorithm-for-Multiple-Sclerosis-Disease-Modifying-Therapies-08-03-2019-1.pdf
- Llywodraeth Cymru Welsh Government (2014) Together for health – a neurological conditions delivery plan. Available at: https://gweddill.gov.wales/docs/dhss/publications/140508neurologicalen.pdf
- Scottish General Standards for Neurological Care and Support (2019). Available at: www.healthcareimprovementscotland.org/our_work/long_term_conditions/neurological_health_services/neurological_care_standards.aspx
- Public Health Agency [Northern Ireland] (2011) Network -Engagement exercise summary report. Available at: www.publichealth.hscni.net/publications/neurological-conditions-network-engagement-exercise-summary-report
- Thompson AJ, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17(2):162-173.
- Kobelt G, et al. Mult Scler. 2017; 23(8):1123-1136.
- Giovannoni G, et al (2015) Brain Health: time matters in multiple sclerosis. Available at: www.msbrainhealth.org/perch/resources/brain-health-time-matters-in-multiple-sclerosis-policy-report.pdf
- Kobelt G, et al Mult Scler. 2019 Apr; 25(5):740-749).
- Secondary care data is taken from the English Hospital Episode Statistics (HES) database produced by the Health & Social Care Information Centre (HSCIC, www.hscic.gov.uk/hes) Copyright © 2018, re-used with the permission of the Health & Social Care Information Centre. All rights reserved.
Biogen-21905 Date of Prep: August 2019