Alemtuzumab for treating highly active relapsing–remitting multiple sclerosis

Alemtuzumab (Lemtrada, Genzyme) is an antibody that binds to cells of the immune system (B and T cells), causing their destruction. The way in which alemtuzumab slows the decline of highly active relapsing–remitting multiple sclerosis is not fully understood. Alemtuzumab has a UK marketing authorisation 'as a single disease modifying therapy in adults with highly active relapsing remitting multiple sclerosis for the following patient groups:

• patients with highly active disease despite a full and adequate course of treatment with at least 1 disease modifying therapy or

• patients with rapidly evolving severe relapsing remitting multiple sclerosis defined by 2 or more disabling relapses in one year, and with 1 or more gadolinium enhancing lesions on brain MRI or a significant increase in T2 lesion load as compared to a previous recent MRI'.
  
  The recommended dosage of alemtuzumab is 12 mg per day administered by intravenous infusion for 2 treatment courses. The initial treatment course lasts 5 consecutive days, followed 12 months later by the second treatment course of 3 consecutive days.

For full details of adverse reactions and contraindications, see the summary of product characteristics.

The price of alemtuzumab is £7,045 per 12‑mg vial, which equates to £56,360 for the full course of treatment consisting of 5 daily consecutive 12‑mg doses in year 1, followed by 3 daily consecutive 12‑mg doses 12 months later in year 2. Costs may vary in different settings because of negotiated procurement discounts.